Claim Review Specialist
3 weeks ago
At Intellivo, we're seeking a skilled Claim Review Specialist to join our team. As a key member of our revenue recovery team, you will be responsible for investigating and identifying instances where bills are paid by both health insurance and liability insurance, and seeking reimbursement from medical providers that were overpaid.
Responsibilities:- Review payout ledgers from first-party insurance carriers or workers' compensation carriers to audit claims paid on behalf of the member and identify possible overpayments
- Investigate and confirm overpayments made to providers
- Seek refunds from medical providers who were overpaid by the health plan's payment
- Identify possible recoveries already received by a client and verify the reason for the reimbursement
- Coordinate with other departments within Intellivo when necessary
- Contact Worker's Compensation Adjusters to verify claim eligibility
- Minimum 2 years' experience in medical billing, insurance recovery, or workers' compensation
- Analytical and detailed in thought and action
- Excellent knowledge of claims processing and coordination of benefits
- Excellent oral, written, and interpersonal skills, including telephone etiquette
- Demonstrated ability to work independently and collaborate with a team
- Ability to multi-task and prioritize work
- Proficiency in Microsoft applications, including Word and Excel
- High school diploma or equivalent
- Some college preferred
- Competitive base compensation plus bonus potential
- Medical insurance
- Dental and vision insurance
- Industry-leading health and wellness benefits
- 401(k) retirement plan
- Generous paid time off
- And more
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