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Recovery Specialist Associate (Subrogation)
Waukesha, WI
Job Description
Description
SHIFT: Day Job
SCHEDULE: Full-time
Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.
Recovery Specialist Associate (Subrogation)
Responsible for identifying and initiating third-party/workers compensation, tracking, and reconciling overpayments made to providers and ensuring that recovery is made and reported under general supervision. Collect and document auto insurance, attorney information and settlement details. Performs all authorized duties in the processing of intake referrals, calls and overpayments allocated to the assigned market consistent with all applicable company and departmental policies.
Hours for this position is 7:30 am - 4:00 pm Central Time/ 8:00 am - 4:30 pm Eastern Time
This position will require you to work remotely from your home. After Covid-19 protocols are lifted and as we return to in office work please note the work locations for this position.
Location: Must reside within 50 miles from an Anthem office. - Louisville, KY - Pewaukee, WI - Indianapolis, IN - Mason, OH
Primary duties may include, but are not limited to:
* Effectively support the Subrogation Recovery Operations team.
* Provides exceptional service to member, providers, group administrators and attorneys who are providing information on, or seeking information about third party/worker's compensation subrogation files.
* Identifies, reviews, sets up or closes health insurance subrogation claims via phone, fax, email or mail. For open cases, collects, records and verifies member information, pertinent accident details, attorney information and third-party liability information. Records detailed and accurate file notes obtained from calls or written correspondence.
* Manage high-volume intake calls and correspondence inventory effectively.
* Determine membership eligibility using various job aids and membership systems.
* Responds to calls, letters, faxes and emails from policyholders, agents, vendors and/or providers
* Show initiative and resourcefulness in solving problems and meeting customer needs.
* Develop relationships with other business units and service partners whose assistance, cooperation and support may be needed.
* Adheres to company and department policies and procedures as well as HIPAA regulations.
* Performs other duties as requested or assigned.
Required Qualifications:
* 2 years of experience in claims and/or customer service or data entry experience; or any combination of education, which would provide an equivalent background
* Proficiency with Microsoft Office products (Outlook, MS Teams, Excel, PowerPoint and Word) and software programs
* Excellent communications skills both oral and written.
Preferred Qualifications:
* HS diploma or equivalent.
* Demonstrated knowledge of subrogation and medical claims.
* Prior health care experience.
* Requires strong problem-solving skills
* Experience with Medicare/Medicaid claims.
* Experience with using a document management system.
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
Job Summary
Company
Anthem, Inc.
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
2+ years
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