Apply on Employer Site

The Phia Group, LLC · 2 hours ago

Sr. Claim Recovery Specialist

Wisconsin, United States

Full-time

Onsite

Mid, Senior Level

$55K/yr - $65K/yr

1+ years exp

The Phia Group is a company that provides claim recovery services for health benefit plans. The Senior Claims Recovery Specialist plays a crucial role in identifying proper payers and pursuing fund reimbursement for medical bills paid by health benefit plans.

ConsultingFinancial ServicesInformation TechnologyLegal

Responsibilities

Calling adjusters and attorneys for status

Negotiating with attorneys

Being familiar with different case laws (with use of passionforsubro.com)

Drafting, mailing & faxing correspondence

Calling insurance carriers for claim information (claim #, adjuster name, phone, fax & mailing address)

Providing clients with accident details, reduction requests, etc

Reviewing plan documents for possible exclusions

Acting as the CH’s out of office (checking voicemail messages and emails)

Will be responsible for consistency and accuracy on time-sensitive documents

Managing a large case load

Using MS Word, Excel, Microsoft Outlook and other programs in preparation of correspondence and/or other documents

Qualification

Subrogation experienceReimbursement experienceNegotiation skillsParalegal CertificateBilingualDecision makingConfidentiality complianceProblem solvingCommunication skills

Required

1-3 years of Subrogation/Reimbursement experience

Must pass applicable test(s) administered by department manager (including the applicable qualification cards)

Strong decision making abilities to determine recovery potential and proper reimbursement

Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

Must have ability to define problems, collect data, establish facts, and draw valid conclusions

Ability to read, write and speak the English language

Preferred

Associates degree or higher

Bilingual (preferred but not required)

Paralegal Certificate (preferred but not required)

Company

The Phia Group, LLC

The Phia Group, LLC, headquartered in Canton, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive consulting services, plan document drafting, subrogation and overpayment recovery, claim negotiation, plan defense, designed to control costs and protect plan assets.

Founded in 1999

Braintree, Massachusetts, USA

201-500 employees