OP Recovery Specialist

Description

Classification:  Non-Exempt

Level: Tier I

Reports to: Overpayment Recovery Supervisor

Overall Compensation: $15 to $17 Per Hour Plus Incentive $4,000 to $6,000 annually (Average Monthly Incentive Payout $500)

JOB DESCRIPTION

Summary/Objective

APU Inc. seeks an Overpayment Recovery Specialist. This position is responsible for investigating and resolving overpayment claims which APU sends to medical, dental and long-term care providers on behalf of its insurance clients.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OP Recovery Specialist I

• Investigate and resolve overpayment claims which APU sends to medical dental and long term care providers on behalf of its insurance clients.
• Make a minimum of 80 calls and spend a minimum of 250 minutes per 8 hour day speaking with medical, dental and long term care providers and policyholders via telephone.
• Perform 2 to 3 hours of administrative duties (notes, research, letter creation, emails, etc.) per day regarding claims.
• Achieve monthly goals/targets (80 calls, 250 minutes)
• Exhibits acceptable level of core attributes (communication, teamwork, professionalism, reliability, respect, etc..)
• Basic level of polices & procedures
• Achieve monthly quality goal (90%)

OP Recovery Specialist II

• Level 1
• Minimum 1 year APU experience
• Exhibits an advance level of core attributes
• Frequently exceeds monthly calling targets (80 calls/250 minutes)
• Achieve monthly quality of 94%
• Certified expert on a specific client (all processes, overpayments and procedures)
• Updating and maintaining a client’s policies, procedures and client lists
• Assist w/training of new callers

OP Recovery Specialist III

• Level 2
• Achieve advanced monthly calling targets of 100 calls/300 minutes)
• Achieve monthly Quality of 97%
• Minimum 18 months APU experience
• Mentor new callers (*Mentor program)
• Special assignments
• Identify and improve processes

Requirements

Competencies

• Ability to perform the essential job functions
• Education and experience
• Professionalism
• Communication Proficiency
• Customer/Client Focus
• Problem Solving/Analysis

Supervisory Responsibility

This position has no supervisory responsibilities.

Required Education and Experience

• High School Diploma or equivalent.
• Possess excellent computer skills
• Possess excellent interpersonal skills, oral and written communication skills
• Be able to work independently
• Be detail oriented, accurate and precise in completing the tasks associated with the position
• Intermediate Windows & MS Office Skills are mandatory.

Preferred Education and Experience

• Experience in processing Long Term Care/Medical/Medicare/Medicaid/Dental or some type of insurance billing or auditing.
• Call center experience
• Customer service experience
• Have Mainframe, “green screen” experience or similar systems
• Have expert knowledge of Microsoft Excel, Word & Outlook.

Additional Eligibility Qualifications  

• Passing of skill test will be required.
• Must attend all days of onboarding training. If unable to attend all days of the training which are held in the first 30 days, the applicant will be rescheduled for the next available training. If unable to attend all days of the rescheduled training, the employee will be released from employment.

· To be considered for this role, please complete the Predictive Index Assessment at:  https://assess.predictiveindex.com/eArRQ.

Internal Candidate Eligibility Qualifications

• Cannot have any written warnings or performance improvement plans currently in place.

Work Authorization

Candidates selected will be subject to a pre-employment background investigation (drug test, credit check, reference verification) and skills test.

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Compensation and Benefits

There will be an attractive compensation package that is commensurate with experience. APU offers a full suite of benefits for full time employees. Those benefits include medical, dental, vision, life, LTD, 401k, PTO and holiday pay. Join our growing team based exclusively in Amarillo, Texas.

Position Type/Expected Hours of Work

This is a full-time position. Days and hours of work are Monday through Friday, 8 a.m. to 5 p.m. This position requires 40 hours per week with some time outside of the normal hours.

Travel

No travel is expected for this position.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee will be required to sit for extended periods of time and is frequently required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

• This position requires sitting over 66% of the time.
• This position requires Visual Acuity at 20 inches (or less) over 66% of the time.

AAP/EEO Statement

APU is an affirmative action/equal opportunity employer (AA/EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, sexual orientation, disability status, genetic information, protected veteran status or any other characteristic protected by federal, state or local law.