Health Claim Coordinator
Health Claim Coordinator
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Job Description
The Phia Group provides amongst other things claim recovery services for health benefit plans. When a health benefit plan pays medical bills and we later discover someone else should have paid those medical bills The Phia Group on behalf of the health plan will seek to recover the funds.
At The Phia Group whose mission is to provide high quality yet affordable healthcare to American employees and their families you can look forward to not only unparalleled benefits for yourself but also being immersed in a company one that recently celebrated its 25th anniversary named one of USA Todays Top Workplaces for 2025. Meanwhile Louisville Business First also recognized our unwavering commitment to upholding an internal culture of inclusivity enjoyment and empathy for our valued employees by listing The Phia Group among its 2025 Best Places to Work.
The Health Claim Coordinator will work in the Case Evaluation Department reviewing both internal and external case referrals for activation/investigation and promote/demote those cases accordingly.
Your primary tasks may include: managing a large volume of referrals from clients attorneys adjusters members and Claim Recovery Specialists. You may also perform additional tasks (on an as-needed basis) to assist with the day-to-day activities of the Recovery Department.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
- Manage a large volume of referrals from clients attorneys adjusters members and Claim Recovery Specialists through email fax and physical correspondence
- Digitally save all electronic referrals to the appropriate system folders
- Correspond with clients attorneys etc. to seek any missing critical information needed to appropriately create cases in the system
- Create subscribers and/or patients within our proprietary system to allow for case activation
- Promptly and accurately assess information received to correctly demote or promote cases for additional handling
- Ensure all case activations are handled within company guidelines
- Add handling attorney and/or adjuster information to the appropriate tabs in the system as-needed
- Log-in and review/retrieve accident questionnaires from select client systems as-needed
- Generate client specific reports on a weekly basis as-needed
- Provide accurate valid and complete information by using correct methods and tools
- Ensure all data entry and data management is in accordance with internal data entry standards and within specific timelines performing audits to ensure accuracy as-needed
- Act as a back-up to the Call Center to ensure adequate phone coverage during company hours
Experience and Qualifications
- High School diploma or equivalent preferred
- Strong verbal and written communication skills
- Excellent attention to detail with the ability to multi-task
- Outstanding organizational interpersonal and administrative skills
- Must have the ability to work as part of a team as well as to work independently
- Must be self-motivated and able to meet deadlines under pressure
Working Conditions / Physical Demands
Sitting at workstation for prolong periods of time. Extensive computer work. Workstation may be exposed to overhead fluorescent lighting and air conditioning. Fast paced work environment. Operates office equipment including personal computer copiers and fax machines.
This job description is not intended to be and should not be construed as an all-inclusive list of all the responsibilities skills or working conditions associated with the position. While it is intended to accurately reflect the position activities and requirements the company reserves the right to modify add or remove duties and assign other duties as necessary.
External and internal applicants as well as position incumbents who become disabled as defined under the Americans with Disabilities Act must be able to perform the essential job functions (as listed here) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis.
Salary: $45000 - $50000
Required Experience:
IC
Employment Type
Full Time
