Data Mining Collections Specialist (Remote) (Healthcare)

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!!!

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.