Claim Review Specialist

Claim Review Specialist

Powered by IntellivoIQ technology, we provide solutions to health providers, billers, health plans, and payers by locating previously undetected auto and workers’ compensation payment sources to increase revenue for our healthcare clients. 

Imagine a place where your talent is treasured, and excellence is rewarded. Now imagine a collaborative culture where every voice is valued. Fueled by over 25 years of experience and our innovative mentality, we continue to grow fast.

Role Summary

As a Claim Review Specialist, you will be responsible for investigating and identifying instances where bills are paid by both the health insurance and liability insurance then seeking reimbursement from the medical providers that were overpaid.

This role is an on-site position at 6075 Poplar Ave., Memphis, TN 38119

• Review payout ledger from first-party insurance carriers or workers’ compensation carriers to audit claims paid on behalf of the member to identify possible overpayments
• Investigate and confirm overpayments made to providers
• Seek refund(s) from medical provider(s) who were overpaid by the health plan’s payment
• Identify possible recoveries already received by a client and verify the reason for the reimbursement
• Coordinate with all other departments within Intellivo when necessary
• Contact Worker’s Compensation Adjuster to verify claim eligibility

Our backgrounds are varied at Intellivo. If these statements sound like you, you might be a good fit for this role:

• Minimum 2 years’ experience in medical billing, insurance recovery, or Worker’s Compensation
• Analytical and detailed in thought and action
• Excellent knowledge of claims processing and coordination of benefits
• Excellent oral, written and interpersonal skills, including telephone etiquette
• Demonstrated ability to work independently and to collaborate with a team
• Ability to multi-task and prioritize work
• Proficiency in Microsoft applications, including Word and Excel
• High school diploma or equivalent
• Some college preferred

• Amazing Team Members – Intellivators!
• Base compensation plus bonus potential
• Medical Insurance
• Dental & Vision Insurance
• Industry leading health & wellness benefits
• 401(K) retirement plan
• Generous Paid Time Off
• And More!