Become a part of EMI Health’s growing organization. EMI Health is an employee benefits firm providing insurance products to companies and individuals in Utah, Arizona and Texas. We provide our employees with an outstanding benefit package that includes paid medical and dental coverage for employees, paid time off, holiday pay, vision, life, disability, HSA and retirement savings plans. In addition, we provide our employees with a fully equipped onsite fitness center and subsidize mass transit passes. We are a tobacco free workplace, hiring non-tobacco users only.
EMI Health is an EEO employer as defined by the EEOC.
SUMMARY OF JOB: Under the direction of the Accounting Manager, the Recovery Specialist investigates claim payment errors for medical and dental claims, determines overpayments, follows up on the recovery process, reconciles refund requests with payments received and prepares daily, weekly, and monthly reports. This is a full-time, non-exempt position. Hours are generally 8:00 a.m. to 5:00 p.m. Monday through Friday.
Uses the claim adjudication system and other resources to investigate medical and dental claims history to resolve recovery issues.
Reconciles and compiles statistical data using Microsoft Excel for recovery reports.
Communicates via telephone and email to resolve problems, answer questions and explain recovery procedures.
Interacts with providers, members, legal counsel and others regarding the recovery and subrogation process.
Prepares new accounts for potential third-party collection efforts.
EDUCATION, EXPERIENCE AND QUALIFICATIONS:
Associates degree preferred; plus one year related experience and/or training; or equivalent combination of education and experience.
Knowledge of medical and dental terminology and claims processing preferred.
Microsoft Office (Excel and Word) proficiency required.
Must be organized and detail oriented, with the ability to prioritize and manage time.
Must be self-motivated and able to function in a team environment.