Recovery Specialist, Medical Recovery Services

Job Description

Job Description Salary: $25.00+ per hour

Recovery Specialist, Medical Recovery Services

Who is Intellivo?

Powered by IntellivoIQ technology, we provide solutions to health providers, billers, health plans, and payers by locating previously undetected auto and workers’ compensation payment sources to increase revenue for our healthcare clients.

Imagine a place where your talent is treasured, and excellence is rewarded. Now imagine a collaborative culture where every voice is valued. Fueled by over 25 years of experience and our innovative mentality, we continue to grow fast.

Role Summary

As the Recovery Specialist, you will be responsible for investigating and resolving Worker’s Compensation, Motor Vehicle, and other Third-Party Liability claims for our healthcare provider and revenue cycle services clients. This includes making telephone calls to members, providers, and insurance companies to gather coordination of benefits and claims status data, researching claims on carrier portals, and/or obtaining and submitting necessary follow-up information (such as Medical Records) in order to resolve unpaid claims. You will be key in investigating and pursuing recoveries and payables while ensuring adherence to state and federal compliance policies, reimbursement policies and contract compliance.

Location

This role is an on-site position in St. Louis, MO.

Responsibilities

Complete case/file set up on MVA/TPL/workers' compensation cases
Obtain all available data relevant to resolving claims on identified cases/events
Work with payers, providers, patients, attorneys, and other involved stakeholders to review case information and identify issues preventing claim resolution
Negotiate recovery amounts with applicable stakeholders (e.g., attorneys, other insurance carriers, members, providers) when necessary to resolve claims
Respond to correspondence requests and/or incoming phone calls related to open cases/claims
Manage, document, and prioritize case load - individual and department (e.g., TAT, schedule/workflow priority adherence)
Adhere to performance expectations related to productivity (daily events worked) and quality standards
Document outcomes of claims investigations in system of record
Develop and maintain relationships with applicable external stakeholders (e.g., providers, carriers, other relevant third parties)
Identify and report opportunities to improve processes, procedures, systems, and/or organizational structures (e.g., to drive improved quality/ efficiency, strengthen stakeholder relationships)
Demonstrate understanding of applicable federal, state, and local compliance regulations (e.g., DOI, DOL, Healthcare Reform/PPACA, CMS)

Qualifications
BS/BA and 1-3 years of experience

OR

equivalent experience.
1-3 years of experience in Revenue Cycle, Call Center Operations, and/or Office Admin.
Strong working knowledge of MS Office & MS Outlook
Driven and outgoing personality
Excellent communicate skills (written & verbal)
Well organized, detail oriented and flexible

Why work for Intellivo?

Amazing Team Members – Intellivators!
Medical Insurance
Dental & Vision Insurance
Industry leading health & wellness benefits
401(K) retirement plan
Generous Paid Time Off
And More!

*Benefit Recovery Group has been renamed Intellivo.

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