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Data Mining Recovery Collections Specialist
#193

JOB SUMMARY

The Collections Specialist pursues collections on errant healthcare claims made to various healthcare provider entities. This role operates in a department that offers a unique combination of deep healthcare expertise and analytics-powered technology solutions to help clients improve operational efficiency, achieve financial integrity, and generate measurable results.

KEY RESPONSIBILITIES

• Make outbound calls to healthcare medical providers to discuss and collect overpayments due to erroneously billed claims.
• Document collection activity within internal databases detailing notes from calls.
• Conduct regular communication with healthcare insurance clients and providers on aging inventory.
• Send refund request letters to healthcare providers via internal system.
• Update team and management on issues/feedback from calls.
• Ensure compliance with HIPAA regulations and requirements.
• Demonstrate Company's Core Competencies and values held within.
• Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE

The incumbent adheres to company policies and procedures to facilitate provider collections and inventory management. An incumbent relies on established instructions and procedures, applies basic skills and may develop advanced skills using tools and equipment appropriate for the position. Duties and tasks are standardized and generally contain written instructions, allowing an incumbent to resolve routine questions and problems. Work is subject to defined work output standards and involves high volume claims collections. Work involves direct contact with internal and external customers.

JOB REQUIREMENTS (Education, Experience, and Training)

• High school diploma or GED along with at least two (2) years of medical billing, collections (call center), and customer service experience. Bachelors' degree in a relevant field is preferred.
• Knowledge or experience with medical coding and regulations preferred.
• Computer skills and familiarity with Microsoft Office programs like Outlook, Word, & Excel.
• Self motivated to ensure individual goals are met or exceeded..
• Ability to prioritize, coordinate, multitask, think outside the box, and be energetic.
• Ability to work independently while maintaining close attention to detail.
• Ability to adapt to a changing environment, manage multiple tasks, and demonstrate outstanding and friendly customer service skills.
• Specifications should support the essential functions identified in the job, assuring compliance with the Americans with Disabilities Act (ADA) and other such employment-related acts
• Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone.

COMPENSATION

The salary range for this position is $42k-$45K. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

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Why Claritev?

Healthcare is complex. We help make it clearer.

At Claritev, you'll do work that matters. Together, we're helping make healthcare more transparent and affordable for all through the power of data, technology, and expertise. We offer meaningful opportunities to grow your career, collaborate with talented colleagues, and make an impact on the clients and communities we serve. If you're looking for purpose, growth, and a team that succeeds together, you'll find it here.

What Guides Us

At Claritev, innovation, agility, and a focus on results drive our success. We embrace bold thinking, work as one team, take ownership, and strive for excellence in everything we do - creating meaningful impact for our clients, communities, and each other.