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Recovery and Resolution Analyst - National Remote

Remote, USA Full-time Posted 2025-11-03
About the position Responsibilities • Investigate, evaluate, and negotiate healthcare subrogation matters for a multi-million dollar portfolio up to $20M (70%) • Comprehend the nuances of Medicare, Medicaid, Self-Funded ERISA and Non-ERISA related health insurance subrogation recoveries and reimbursements • Research applicability of laws, regulations and other requirements to cases, contracts or decisions • Analyze data and interpret legal research to make conclusions and present results • Maintain working knowledge of ERISA and ensure adherence to state and federal subrogation laws • Identify, monitor and evaluate data to determine third party liability and reimbursement amounts • Conduct a high volume of outbound calls and respond to inquiries (20%) • Communicate effectively with various parties throughout the subrogation recovery process • Validate claim liability, adjuster's contact information, claim status, and treatment status • Thoroughly document all communications and maintain case activity calendar diaries (10%) • Ensure compliance with Health Insurance Portability and Accountability Act • May be involved with litigation as necessary • Negotiate settlements with adverse parties with professionalism and integrity • Recommend and participate in round table discussions of complex cases • Act as coach and mentor to other team members • Assist management on special projects and any other assigned tasks Requirements • High School Diploma / GED • Must be 18 years of age OR Older • 2+ years of healthcare claims experience • Experience working in healthcare insurance • Understanding of subrogation principles • Ability to work any of the 8-hour shift schedules during normal business hours Nice-to-haves • P&C (Property & Casualty) insurance experience • Demonstrated negotiation experience • Knowledge of local, state and federal laws and regulations pertaining to insurance • Experience working with claims and/or recovery Benefits • Comprehensive benefits package • Incentive and recognition programs • Equity stock purchase • 401k contribution Apply tot his job Apply To this Job

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