Compliance Agent I – Medical Collections Team

State of Utah

Full Job Description
Job Description


The Office of Recovery Services help ensure that parents are financially responsible for their children by providing child support services.

Are you looking for an opportunity to grow and expand your skills in an interesting and rewarding line of work? If so, this career may be the one for you! This position requires no degree and offers excellent benefits with a Monday through Friday, 8:00 – 5:00 schedule to allow more time to spend with your family instilling a positive work-life balance.

The hourly rate of pay goes up to $19.89 per hour upon successful completion of a one-year probation period!

Why You Should Join Our Team
You will not only be working with a great team, you will receive great health and retirement benefits, along with paid time off and 12 paid holidays off per year. Find out more about the benefits that make working for the State of Utah awesome, by clicking here. This is an outstanding opportunity for an outstanding individual!

The Office of Recovery Services in Taylorsville is looking for a dedicated person to work as a Health Claim Agent, Compliance Agent I.

Principle Duties:
We are looking for someone who is able to perform a full range of professional research and/or collection tasks, using automated computer systems and associated business practice while performing the following tasks:

Researching to identify and verify potentially liable third parties and ensure that the Utah State Medicaid program is the payer of last resort;
Ensuring the accuracy of insurance coverage of Medicaid recipients by utilizing online verification sources and/or in person insurance company contacts and adds or updates verified insurance information to computer systems;
Pursuing the collection of obligations, over payments, and other debts owed to the state in regards to Medicaid reimbursement;
Reviewing Medicaid paid claims information maintained in state computer systems using knowledge of state and federal statute, insurance coverage and practice, and filing appropriate claims to reimburse the Medicaid program;
Contacting insurance companies to determine the status of filed claims by utilizing online resources and/or personal contact;
Maintaining accurate computer system accounting records for medical debts to ensure that receipts are posted in accordance with established state business practice;
Reviewing insurance company explanations of benefits to determine if payments and/or non payments for reimbursement were made in accordance with insurance company practice and state and federal statute;
Negotiating settlement of claims using persuasive skills and legal authority;
Providing excellent customer service for clients/customers in various state agencies and private companies;
Maintaining proficient computer skills in various state systems and online resources;
Applying knowledge of agency rules, regulations, and policies.

Ideal Candidate:
The model candidate for this position is someone who:Is proficient with a ten key
Is proficient in a technologically driven environment with intermediate to advanced computer skills.
Deals with people in a manner which shows sensitivity, tact, and professionalism
Has an exceptional ability to multi-task and quickly make decisions.
Has strong customer service and communication skills with an ability to assist people in a manner which shows sensitivity, tact and professionalism, without prejudice or bias.
Will effectively contact individuals or organizations to secure delinquent payments, and/or make payment arrangements for money owed.
Is able to interpret, clarify, explain and apply agency policy and procedures, business practices, federal or state laws and regulations.

The Agency
The Office of Recovery Services is part of the Department of Health and Human Services (DHHS). For more information on the Office of Recovery Services, please click here.

Supplemental Information
Working Conditions:

Risks found in the typical office setting, which is adequately lighted, heated and ventilated, e.g., safe use of office equipment, avoiding trips and falls, observing fire regulations, etc..
Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.

To apply for this job please visit