Skip to Main Content

Funds Recovery

The Health Plan of West Virginia Inc Wheeling, WV

  • Posted: over a month ago
  • Full-Time
Job Description

The Funds Recovery Representative is responsible for handling all subrogation recoveries, Claims Audit Recoveries, Amounts paid for Retro-Termed Members and return payments. Also, when needed, will request refunds for claims payment corrections. 


  1. Familiarity with medical terminology and medical claims, effective computer, analytical, organizational and customer skills; experience with computer spreadsheets and word processing.
  2. Excellent telephone skills.
  3. Ability to multi-task.


  • Experience in accounts receivable collections.


  • Identify Eligibility of HP members;
  • Log all calls on a Service Form in EXP;
  • Review and process various Reports (e.g. Retro-Termed Members, etc.);
  • Generate Letters to Members (mainly for Retro-Termed Members);
  • Send Refund Request Letters to Providers [e.g. Credit Balances Print Que, Dupe Reports];
  • Process Collection Notices to Members/Providers;
  • Process and Submit Accident Reports to Subrogation Vendors;
  • Process and Post Recoveries (Cash, Voids, Subrogation & Reinsurance);
  • Perform Take-Backs of Prior Payments;
  • Balance Recoveries at the End of Each Month;
  • Manage Calls from Members, Providers and Attorneys regarding Funds Recovery Issues;
  • Run Required Reports;
  • Post recoveries from Hospital & Facility Audits;
  • Manage Hanging Credits and Associated Reports;
  • Submit Monthly Totals and Reporting to Administration;
  • Troubleshoot Issues with Vendors or Internal Processes.

The Health Plan of West Virginia Inc


Wheeling, WV
26003 USA


Finance and Insurance

View all jobs at The Health Plan of West Virginia Inc

What email should the hiring manager reach you at?

By clicking the button above, I agree to the ZipRecruiter Terms of Use and acknowledge I have read the Privacy Policy, and agree to receive email job alerts.