Senior Claim Recovery Specialist

🕒 October 20

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $50k - $65k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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The Phia Group, LLC

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2000

💼 Consulting

🏥 Healthcare

🛡️ Insurance

💰 Private Equity Round on 2018-09

Consulting • Healthcare • Insurance

The Phia Group, LLC is a dedicated provider of healthcare cost containment solutions, focusing on empowering self-funded health plans to maximize benefits and minimize costs. Through a comprehensive suite of services, including subrogation and recovery, claims negotiation, and cost transparency initiatives, The Phia Group aims to help employers and families navigate the complexities of healthcare with advocacy and expertise. Their commitment to improving healthcare accessibility and affordability sets them apart in the industry.

📋 Description

• Handle files for the Recovery Department • Communicate with attorneys, adjusters, and plan participants to determine potential recovery sources • Communicate with clients, including health benefit plan sponsors, employers, and claims administrators, by phone and email • Call adjusters and attorneys for status updates • Negotiate with attorneys • Apply knowledge of different case laws using passionforsubro.com • Draft, mail, and fax correspondence • Call insurance carriers for claim information • Provide clients with accident details and reduction requests • Review plan documents for possible exclusions • Act as the Claims Handler’s out of office by checking voicemail messages and emails • Ensure consistency and accuracy of time-sensitive documents • Manage a large caseload • Use MS Word, Excel, Microsoft Outlook, and other programs to prepare correspondence and documents • Perform additional day-to-day Recovery Department tasks as needed

🎯 Requirements

• Associates degree or higher preferred • 1-3 years of Subrogation/Reimbursement experience • Must pass applicable tests administered by the department manager, including applicable qualification cards • Strong decision-making abilities to determine recovery potential and proper reimbursement • Maintain confidentiality and comply with HIPAA • Ability to define problems, collect data, establish facts, and draw valid conclusions • Ability to read, write, and speak English • Bilingual preferred but not required • Paralegal Certificate preferred but not required • Ability to perform essential job functions unaided or with reasonable accommodation • Extensive computer work and ability to operate office equipment including personal computers, copiers, and fax machines

🏖️ Benefits

• Exceptional benefits for employees • Company-recognized inclusive, enjoyable, and empathetic workplace culture • Reasonable accommodation for disabled employees as determined by management

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