Insurance Claims Auditor
24 hours ago
Salary: $40k +
About Intellivo:
At Intellivo, we leverage our proprietary IntellivoIQ technology to deliver innovative solutions for healthcare providers, billing professionals, health plans, and payers. Our mission is to uncover previously overlooked sources of auto and workers' compensation payments, ultimately enhancing revenue for our clients in the healthcare sector.
Position Summary:
The Claim Review Specialist plays a crucial role in examining and identifying situations where medical bills have been reimbursed by both health and liability insurance. This position involves pursuing refunds from medical providers for any overpayments made.
Key Responsibilities:
- Analyze payout ledgers from first-party insurance or workers' compensation carriers to audit claims paid on behalf of members and identify potential overpayments.
- Conduct thorough investigations to confirm overpayments made to healthcare providers.
- Request refunds from medical providers who have received excess payments from health plans.
- Assess recoveries already received by clients and verify the reasons for these reimbursements.
- Collaborate with various departments within Intellivo as needed.
- Engage with Worker's Compensation Adjusters to validate claim eligibility.
Qualifications:
We value diverse backgrounds at Intellivo. The ideal candidate will possess:
- A minimum of 2 years of experience in medical billing, insurance recovery, or workers' compensation.
- Strong analytical skills and attention to detail.
- Comprehensive understanding of claims processing and coordination of benefits.
- Exceptional verbal, written, and interpersonal communication skills.
- The ability to work independently while also being a collaborative team player.
- Capability to manage multiple tasks and prioritize effectively.
- Proficiency in Microsoft Office applications, particularly Word and Excel.
- A high school diploma or equivalent; some college education is preferred.
Why Choose Intellivo?
- Collaborative and supportive team environment.
- Competitive base salary with bonus opportunities.
- Comprehensive medical, dental, and vision insurance.
- Leading health and wellness benefits.
- 401(K) retirement savings plan.
- Generous paid time off policies.
- And much more
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