Health Claim Coordinator

Job Description

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 Today’s 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 Coordinaotr 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

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 : $45,000 - $50,000