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Elevance Health

Sells health insurance and pharmacy benefits

Recovery Specialist Associate - Call Center

Claims AdjudicationPosted on Nov 13
Full-time

About the Job

Requirements

  • A minimum of 2 years of claims or data-entry experience, or an equivalent combination of education and experience.
  • A high school diploma or GED is preferred.
  • Prior call-center experience is strongly preferred.
  • Medical claims processing experience is preferred.
  • Proficiency with Microsoft Office products, including Outlook, Microsoft Teams, Excel, PowerPoint, and Word, and software programs is preferred.
  • Prior health care experience is preferred.
  • Strong problem-solving skills are preferred.
  • Strong oral and written communication skills are preferred.

Responsibilities

  • Support the Subrogation Recovery Operations team.
  • Provide service to members, providers, group administrators, and attorneys providing or seeking information about third-party or workers’ compensation subrogation files.
  • Identify, review, set up, or close health insurance subrogation claims through phone, fax, email, or mail.
  • For open cases, collect, record, and verify member information, accident details, attorney information, and third-party liability information.
  • Record detailed and accurate file notes from calls or written correspondence.
  • Manage high-volume intake calls and correspondence inventory.
  • Determine membership eligibility using job aids and membership systems.
  • Respond to calls, letters, faxes, and emails from policyholders, agents, vendors, and providers.
  • Solve problems and meet customer needs using initiative and resourcefulness.
  • Develop relationships with business units and service partners whose cooperation or support may be needed.
  • Follow company and department policies and procedures, including HIPAA regulations.
  • Perform other duties as requested or assigned.

About the Company

Elevance Health

Sells health insurance and pharmacy benefits

Elevance Health is one of the largest U.S. health insurers, covering people through employers, individual plans, Medicare and Medicaid. It is the Blue Cross Blue Shield licensee in 14 states, where it sells plans under the Anthem name, and it runs government plans under the Wellpoint name in other markets. Its Carelon division runs the CarelonRx pharmacy benefit manager and sells behavioral health, care management and other services to its own plans and outside clients. Elevance earns most of its revenue from premiums paid by employers, members and government programs, plus fees for Carelon services. The company is headquartered in Indianapolis, Indiana.

Company size
10,001+
Company stage
IPO
Headquarters
Indianapolis, IN
Founded
1944

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