Recovery Specialist, Medical Recovery Services

Recovery Specialist, Medical Recovery Services

Powered by IntellivoIQ technology, we provide solutions to health providers, billers, health plans, and payers by locating previously undetected auto and workers’ compensation payment sources to increase revenue for our healthcare clients. 

Imagine a place where your talent is treasured, and excellence is rewarded. Now imagine a collaborative culture where every voice is valued. Fueled by over 25 years of experience and our innovative mentality, we continue to grow fast.

Role Summary

As the Recovery Specialist, you will be responsible for investigating and resolving Worker’s Compensation, Motor Vehicle, and other Third-Party Liability claims for our healthcare provider and revenue cycle services clients. This includes making telephone calls to members, providers, and insurance companies to gather coordination of benefits and claims status data, researching claims on carrier portals, and/or obtaining and submitting necessary follow-up information (such as Medical Records) in order to resolve unpaid claims. You will be key in investigating and pursuing recoveries and payables while ensuring adherence to state and federal compliance policies, reimbursement policies and contract compliance.

This role is an on-site position in St. Louis, MO. 

• Complete case/file set up on MVA/TPL/workers' compensation cases

• Obtain all available data relevant to resolving claims on identified cases/events

• Work with payers, providers, patients, attorneys, and other involved stakeholders to review case information and identify issues preventing claim resolution

• Negotiate recovery amounts with applicable stakeholders (e.g., attorneys, other insurance carriers, members, providers) when necessary to resolve claims

• Respond to correspondence requests and/or incoming phone calls related to open cases/claims

• Manage, document, and prioritize case load - individual and department (e.g., TAT, schedule/workflow priority adherence)

• Adhere to performance expectations related to productivity (daily events worked) and quality standards

• Document outcomes of claims investigations in system of record

• Develop and maintain relationships with applicable external stakeholders (e.g., providers, carriers, other relevant third parties)

• Identify and report opportunities to improve processes, procedures, systems, and/or organizational structures (e.g., to drive improved quality/ efficiency, strengthen stakeholder relationships)

• Demonstrate understanding of applicable federal, state, and local compliance regulations (e.g., DOI, DOL, Healthcare Reform/PPACA, CMS)

• BS/BA and 1-3 years of experience OR High School Diploma and 7+ years of experience

• 1-3 years of experience in Revenue Cycle, Call Center Operations, and/or Office Admin.

• Strong working knowledge of MS Office & MS Outlook

• Driven and outgoing personality

• Excellent communicate skills (written & verbal)

• Well organized, detail oriented and flexible

• Amazing Team Members – Intellivators!
• Medical Insurance
• Dental & Vision Insurance
• Industry leading health & wellness benefits
• 401(K) retirement plan
• Generous Paid Time Off
• And More!