Recovery and Resolution Analyst - National Remote
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
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