Recovery Specialist Associate - Call Center

Recovery Specialist Associate – Call Center Hybrid: This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Shift: Monday-Friday; 10:30am - 7:00pm EST The Recovery Specialist Associate is responsible for identifying, tracking, and reconciling overpayments made to providers and ensuring that recovery is made and reported under general supervision. Performs all authorized duties in the processing of overpayments allocated to the assigned market consistent with all applicable company and departmental policies. Responsibilities 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. Minimum Requirements Requires H.S. diploma or GED preferred, a minimum 2 years of claims or data entry experience; or any combination of education and experience, which would provide an equivalent background. Preferred Skills, Capabilities, and Experiences Prior call center experience strongly preferred. Medical claims processing experience preferred. Proficiency with Microsoft Office products (Outlook, MS Teams, Excel, PowerPoint and Word) and software programs preferred. Excellent communications skills both oral and written preferred. Prior health care experience preferred. Strong problem-solving skills preferred. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact View email address on click.appcast.io for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. #J-18808-Ljbffr