The Funds Recovery Representative is responsible for handling all subrogation recoveries, Claims Audit Recoveries, Amounts paid for Retro-Termed Members and return payments. Also, when needed, will request refunds for claims payment corrections. Required:
Familiarity with medical terminology and medical claims, effective computer, analytical, organizational and customer skills; experience with computer spreadsheets and word processing. Excellent telephone skills. Ability to multi-task. Desired:
Experience in accounts receivable collections. Responsibilities:
Identify Eligibility of HP members; Log all calls on a Service Form in CSR Encounter Form; Review and process various Reports (e.g. Retro-Termed Members, etc.; Generate Letters to Members (mainly for Retro-Termed Members); Send Refund Request Letters to Providers [e.g. Credit Balances Report, Dupe Reports]; Process Collection Notices to Providers; Process and Submit Accident Reports to Subrogation Vendors; Process and Post Recoveries (Cash, Voids, Subrogation & Reinsurance); Perform claim adjustments of Prior Payments; Balance Recoveries at the End of Each Month; Manage Calls from Members, Providers and Attorneys regarding Funds Recovery Issues; Run Required Reports; Post recoveries from Hospital & Facility Audits; Manage Hanging Credits and Associated Reports; Submit Monthly Totals and Reporting to Administration; Troubleshoot Issues with Vendors or Internal Processes.