Recovery Specialist I or II (Claims,A/R,Collections) Kentucky or - (US-IN-Indianapolis - 46298)

Minimum Education: Tech School
Job Type: Full Time
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Anthem Blue Cross and Blue Shield
is a proud member of the WellPoint family of companies. At Anthem, we are dedicated to our mission of improving the health of the people we serve. We believe the best health care coverage can actually help people stay healthy.
Bring your expertise to our innovative, performance-focused culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.
The Recovery Specialist I
is responsible for handling overpayments or reimbursement from other parties who may be liable for payment of claims. This level handles more routine issues.
Essential duties include, but are not limited to:
Determines and calculates amount of overpayment.
Issues refund request letters, notice letters, or med lists.
Processes voluntary refunds.
Adjusts claims based on refund received.
Performs other duties as assigned.

The Recovery Specialist II
is responsible for pursuing claims overpayments or reimbursements from other parties who may be liable for payment of claims. This level handles more complex issues, such as auditing and adjusting claims, COB, Medicare, Worker's Compensation or Subrogation . Essential duties include, but are not limited to:
Determines reason for overpayment or other party liability.
Calculates amount of overpayment.
Issues refund request letters or lien notices.
Responds to rebuttals and corresponds with involved parties.
Adjusts claims as required based on refund.
Performs other duties as assigned.

Skills:
Recovery Specialist I Requires high school diploma or equivalent and 2 years experience in claims and/or customer service. Knowledge of FACETS, relevant claims systems and related software, desired; Requires good PC skills. Requires strong problem-solving and oral and written communication skills.Recover Specialist II Requires high school diploma or equivalent and 4 years related experience in operations. Knowledge of SR Facets systems, claims systems and related software and good PC skills. Requires strong problem-solving and oral and written communication skills.WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2008 DiversityInc magazine Top 50 Company for Diversity.

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