Health Claim Investigation Representative

The Phia Group provides claim recovery services for health benefit plans, and they are seeking a Health Claim Investigation Representative to aid in recovering funds for medical bills. The role involves communicating with plan members and insurance carriers to gather necessary information for claims reimbursement.ResponsibilitiesCalling members for accident detailsDrafting, mailing & faxing correspondenceCalling insurance carriers for claim information (claim #, adjuster name, phone, fax & mailing address)Providing clients with accident details, payment ledgers, police reports, etcReviewing plan documents for possible exclusionsVerifying first party, workers’ compensation, third party and/or attorney representation and properly promoting and/or transferring the file to the appropriate CRSWill be responsible for consistency and accuracy on time-sensitive documentsWorking on a team to efficiently handle tasks and keep the team up to dateUsing MS Word, Excel, Microsoft Outlook and other programs in preparation of correspondence and/or other documentsSkillsExcellent attention to detail with the ability to multi-taskExcellent communication skillsHigh level of proficiency using Microsoft Word and Excel requiredOutstanding organizational, interpersonal, and administrative skillsExcellent telephone, writing, and communication skillsMust be self-motivated and able to meet deadlines under pressureMust have the ability to work as part of a team, as well as to work independentlyCompany OverviewThe 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. It was founded in 1999, and is headquartered in Braintree, Massachusetts, USA, with a workforce of 201-500 employees. Its website is http://phiagroup.com.



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