Recovery Specialist Associate - Call Center

Hybrid 1: This role requires associates be in the office 1-2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

The Recovery Specialist Associate is responsible for identifying, tracking, and reconciling over payments made to providers and ensuring that recovery is made and reported under general supervision. Performs all authorized duties in the processing of over payments allocated to the assigned market consistent with all applicable company and departmental policies.

• Effectively support the Subrogation Recovery Operations team.
• Provides exceptional service to member, providers, group administrators and attorneys who are providing information on, or seeking information about third party/worker’s compensation subrogation files.
• Identifies, reviews, sets up or closes health insurance subrogation claims via phone, fax, email or mail. For open cases, collects, records and verifies member information, pertinent accident details, attorney information and third-party liability information. Records detailed and accurate file notes obtained from calls or written correspondence.
• Manage high-volume intake calls and correspondence inventory effectively.
• Determine membership eligibility using various job aids and membership systems.
• Responds to calls, letters, faxes and emails from policyholders, agents, vendors and/or providers
• Show initiative and resourcefulness in solving problems and meeting customer needs.
• Develop relationships with other business units and service partners whose assistance, cooperation and support may be needed.
• Adheres to company and department policies and procedures as well as HIPAA regulations.
• Performs other duties as requested or assigned.

• Requires H.S. diploma or GED preferred, a minimum 2 years of claims or data entry experience; or any combination of education and experience, which would provide an equivalent background.

• Prior call center experience strongly preferred.
• Medical claims processing experience preferred.
• Proficiency with Microsoft Office products (Outlook, MS Teams, Excel, PowerPoint and Word) and software programs preferred.
• Excellent communications skills both oral and written preferred.
• Prior health care experience preferred.
• Strong problem-solving skills preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our…