Recovery Specialist Associate - Call Center

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.

Carelon, a proud member of the Elevance Health family of companies, is a healthcare services organization that takes a whole-health approach to making care more integrated, personalized, and affordable. We put people at the center—connecting physical, behavioral, social, and pharmacy services, along with clinical expertise, research, operations, and advanced technology to help care work better, together.

Among us are specialty-care physicians, nurse practitioners, pharmacists, engineers, data scientists, and other dedicated and caring health professionals. While our roles may differ, our purpose is shared: to make a positive impact on whole health.

Shift: Monday- Friday; 10:30am - 7:00pm EST

The Recovery Specialist Associate - Call Center 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.

How you will make an impact:

• 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.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $19.18 to $30.14

Locations: Colorado, Nevada.

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.