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The Phia Group, LLC · 9 hours ago

Health Claim Investigation Representative

Louisville, KY

Full-time

Hybrid

New Grad, Entry Level

$47K/yr - $50K/yr

The Phia Group, LLC provides claim recovery services for health benefit plans and is seeking a Health Claim Investigation Representative. This role involves communicating with plan members and insurance carriers to determine sources of recovery and assist in fund reimbursement efforts.

ConsultingFinancial ServicesInformation TechnologyLegal

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

Qualification

Microsoft WordMicrosoft ExcelCommunication skillsAttention to detailOrganizational skills

Required

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

The Phia Group, LLC

The Phia Group, LLC, headquartered in Canton, Massachusetts, is an experienced provider of health care cost containment techniques offering comprehensive consulting services, plan document drafting, subrogation and overpayment recovery, claim negotiation, plan defense, designed to control costs and protect plan assets.

Founded in 1999