Data Mining Recovery Collections Specialist

At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple – we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external – driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!! Do you know someone who you think would be a great fit for this position? To share this job with someone, click the refer-a-friend icon at the top of this page. This icon is to the right of the star icon. JOB SUMMARY: The Collections Specialist pursues collections on errant healthcare claims made to various healthcare provider entities. This role operates in a department that offers a unique combination of deep healthcare expertise and analytics-powered technology solutions to help clients improve operational efficiency, achieve financial integrity, and generate measurable results. JOB ROLES AND RESPONSIBILITIES: 1. Make outbound calls to healthcare medical providers to discuss and collect overpayments due to erroneously billed claims. 2. Document collection activity within internal databases detailing notes from calls. 3. Conduct regular communication with healthcare insurance clients and providers on aging inventory. 4. Send refund request letters to healthcare providers via internal system. 5. Update team and management on issues/feedback from calls. 6. Ensure compliance with HIPAA regulations and requirements. 7. Demonstrate Company’s Core Competencies and values held within. 8. Please note due to the exposure of PHI sensitive data — this role is considered to be a High Risk Role. 9. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary. JOB SCOPE: The incumbent adheres to company policies and procedures to facilitate provider collections and inventory management. An incumbent relies on established instructions and procedures, applies basic skills and may develop advanced skills using tools and equipment appropriate for the position. Duties and tasks are standardized and generally contain written instructions, allowing an incumbent to resolve routine questions and problems. Work is subject to defined work output standards and involves high volume claims collections. Work involves direct contact with internal and external customers. Qualifications JOB REQUIREMENTS (Education, Experience, and Training): * High school diploma or GED along with at least two (2) years of medical billing, collections (call center), and customer service experience. Bachelors’ degree in a relevant field is preferred. * Knowledge or experience with medical coding and regulations preferred. * Computer skills and familiarity with Microsoft Office programs like Outlook, Word, & Excel. * Self motivated to ensure individual goals are met or exceeded.. * Ability to prioritize, coordinate, multitask, think outside the box, and be energetic. * Ability to work independently while maintaining close attention to detail. * Ability to adapt to a changing environment, manage multiple tasks, and demonstrate outstanding and friendly customer service skills. * Specifications should support the essential functions identified in the job, assuring compliance with the Americans with Disabilities Act (ADA) and other such employment-related acts * Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone. BENEFITS We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities. Your benefits will include: · Medical, dental and vision coverage with low deductible & copay · Life insurance · Short and long-term disability · Paid Parental Leave · 401(k) + match · Employee Stock Purchase Plan · Generous Paid Time Off – accrued based on years of service o WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service · 10 paid company holidays · Tuition reimbursement · Flexible Spending Account · Employee Assistance Program · Summer Hours · Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits. The salary range for this position is $42k-45K annually, paid at an hourly rate. Specific offers take into account a candidate’s education, experience and skills, as well as the candidate’s work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity. EEO STATEMENT Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here. APPLICATION DEADLINE We will generally accept applications for at least 5 calendar days from the posting date or as long as the job remains posted. #LI-SW1 .