Health Claim Investigation Representative
The Phia Group provides claim recovery services for health benefit plans, and they are seeking a Health Claim Investigation Representative to aid in recovering funds for medical bills. The role involves communicating with plan members and insurance carriers to gather necessary information for claims reimbursement.
Responsibilities
- Calling members for accident details
- Drafting, mailing & faxing correspondence
- Calling insurance carriers for claim information (claim #, adjuster name, phone, fax & mailing address)
- Providing clients with accident details, payment ledgers, police reports, etc
- Reviewing plan documents for possible exclusions
- Verifying first party, workers’ compensation, third party and/or attorney representation and properly promoting and/or transferring the file to the appropriate CRS
- Will be responsible for consistency and accuracy on time-sensitive documents
- Working on a team to efficiently handle tasks and keep the team up to date
- Using MS Word, Excel, Microsoft Outlook and other programs in preparation of correspondence and/or other documents
Skills
- Excellent attention to detail with the ability to multi-task
- Excellent communication skills
- High level of proficiency using Microsoft Word and Excel required
- Outstanding organizational, interpersonal, and administrative skills
- Excellent telephone, writing, and communication skills
- Must be self-motivated and able to meet deadlines under pressure
- Must have the ability to work as part of a team, as well as to work independently
Company Overview