Call Center Representative (Healthcare / Subrogation)
About The Position
Responsibilities include, investigating new potentials cases, placing outbound calls as well as submitting correspondence to health plan members, insurance companies, and attorney offices. The Subrogation Specialist coordinates efforts with other members of the subrogation team to maximize recovery in accordance with EXL's Subrogation Policies and Procedures. Complying with HIPAA regulations as well as EXL's HIPAA and Information Security policies and procedures, including required training and incident reporting. EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions. From your very first day, you get an opportunity to work closely with highly experienced, world-class Healthcare consultants. You can expect to learn about many aspects of businesses that our clients engage in. You will also learn effective teamwork and time management skills - key aspects for personal and professional growth. We provide guidance/ coaching to every employee through our mentoring program where in every junior level employee is assigned a senior level professional as advisors. Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond. Learn and understand fundamentals of health insurance subrogation, including basic health plan contractual provisions that apply to the reimbursement efforts. Review, Identify and develop subrogation opportunities by gathering missing information and potential sources of recovery. Place parties of interest on notice Organize and structure investigations to work in priority order using the tools provided. Respond timely to all electronic, written, and verbal communications. Log and maintain detailed and accurate records. Access and pull benefits from clients' health claim systems. Pursue worker's compensation, third party liability, first party uninsured and underinsured recovery, worker's compensation, med-pay coverage, and no-fault recoveries. Engage advice and/or help of legal manager to proactively resolve cases. Ensure compliance of state and federal laws Adhere to settlement authority levels. Maintain department productivity and quality standards. Sensitivity to privacy in accordance with HIPAA guidelines
Requirements
- Working knowledge of Microsoft Word, Excel, internet research skills
- High School or equivalent education level
- Developed customer service skills.
- Strong organizational and time management skills
- Ability to work independently and as part of a team.
Nice To Haves
- 1+ years of subrogation experience
- 1+ years of claims experience.
- 1+ years of heavy call volume support experience
Responsibilities
- Investigating new potentials cases
- Placing outbound calls
- Submitting correspondence to health plan members, insurance companies, and attorney offices
- Coordinating efforts with other members of the subrogation team to maximize recovery in accordance with EXL's Subrogation Policies and Procedures
- Complying with HIPAA regulations as well as EXL's HIPAA and Information Security policies and procedures, including required training and incident reporting
- Learn and understand fundamentals of health insurance subrogation, including basic health plan contractual provisions that apply to the reimbursement efforts
- Review, Identify and develop subrogation opportunities by gathering missing information and potential sources of recovery
- Place parties of interest on notice
- Organize and structure investigations to work in priority order using the tools provided
- Respond timely to all electronic, written, and verbal communications
- Log and maintain detailed and accurate records
- Access and pull benefits from clients' health claim systems
- Pursue worker's compensation, third party liability, first party uninsured and underinsured recovery, worker's compensation, med-pay coverage, and no-fault recoveries
- Engage advice and/or help of legal manager to proactively resolve cases
- Ensure compliance of state and federal laws
- Adhere to settlement authority levels
- Maintain department productivity and quality standards
- Sensitivity to privacy in accordance with HIPAA guidelines
Benefits
- EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.
- From your very first day, you get an opportunity to work closely with highly experienced, world-class Healthcare consultants.
- You can expect to learn about many aspects of businesses that our clients engage in.
- You will also learn effective teamwork and time management skills - key aspects for personal and professional growth.
- We provide guidance/ coaching to every employee through our mentoring program where in every junior level employee is assigned a senior level professional as advisors.
- Sky is the limit for our team members.
- The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
