Recovery Specialist II
Posted on: 9 Apr 2021
Cerritos, CA
Job Description
Description
SHIFT: Day Job
SCHEDULE: Full-time
Recovery Specialist II
Days
Location: Cerritos, CA
The Recovery Specialist II is responsible for pursuing claims overpayments or reimbursements from other parties who may be liable for payment of claims. This level handles more complex issues, such as auditing and adjusting claims, COB, Medicare, Worker's Compensation, or subrogation.
Essential duties include but are not limited to:
Determines reason for overpayment or other party liability.
Calculates amount of overpayment.
Issues refund request letters or lien notices.
Responds to rebuttals and corresponds with involved parties.
Adjusts claims as required based on refund. Performs other duties as assigned.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Anthem, Inc. is ranked as one of Americas Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
Qualifications
Qualifications:
Requires high school diploma or equivalent and 4 years related experience in operations.
Must have knowledge of relevant claims systems and related software and good PC skills . Requires strong problem-solving and oral and written communication skills.
Must have medical claims experience
Anthem, Inc.
Indianapolis, IN
Anthem, Inc., through its subsidiaries, operates as a health benefits company in the United States. It operates through three segments: Commercial & Specialty Business, Government Business, and Other. The company offers a spectrum of network-based managed care health benefit plans to large and small group, individual, Medicaid, and Medicare markets. Its managed care plans include preferred provider organizations; health maintenance organizations; point-of-service plans; traditional indemnity plans and other hybrid plans, such as consumer-driven health plans; and hospital only and limited benefit products.
The company also provides a range of managed care services to self-funded customers, including claims processing, underwriting, stop loss insurance, actuarial services, provider network access, medical cost management, disease management, wellness programs, and other administrative services. In addition, it offers an array of specialty and other insurance products and services, such as dental, vision, life and disability insurance benefits, radiology benefit management, and analytics-driven personal health care guidance; and Medicare administrative services.
Further, the company provides services to the federal government in connection with the Federal Employee Program; and operates as a licensee of the Blue Cross and Blue Shield Association. As of December 31, 2018, it served 40 million medical members through its affiliated health plans. The company was formerly known as WellPoint, Inc. and changed its name to Anthem, Inc. in December 2014. Anthem, Inc. was founded in 1944 and is headquartered in Indianapolis, Indiana.
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IndustryHealthcare
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No. of Employees63,900
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Website
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Jobs Posted1634
