MVA/Third Party Liability Resolution Specialist II

Emploi pas sur LinkedIn

🕒 il y a 7 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👻 Score fantôme 10%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Revco Solutions

Site WebLinkedInTous les Emplois

501 - 1000 employés

🏥 Santé

🛡️ Assurance

💼 Conseil

Healthcare • Insurance • Consulting

Revco Solutions est un fournisseur de premier plan de services de gestion du cycle de revenus, spécialisé dans le recouvrement de créances du secteur de la santé et la conformité. Avec un engagement vers l'excellence, ils offrent des solutions sur mesure qui améliorent la performance tout en garantissant les normes les plus élevées de sécurité et de conformité. Leur équipe expérimentée se consacre à l'amélioration de la santé financière des organisations de santé en optimisant les efforts de recouvrement et en fournissant des expériences supérieures aux clients et aux patients.

Description

• Independently manage complex MVA/TPL accounts from initial investigation through final resolution • Analyze registration, diagnosis, accident, insurance, clinical, billing, payment, legal, and account information to determine recovery strategy • Investigate accident circumstances, responsible parties, liability status, available coverage, claim numbers, policy limits, attorney representation, multiple claimants, and other reimbursement sources • Identify and pursue primary, secondary, and alternative recovery sources • Evaluate, prepare, submit, document, monitor, and manage hospital liens and related notices • Monitor settlements, lien deadlines, documentation requirements, coverage issues, and account milestones • Communicate and negotiate with liability insurance carriers, claims adjusters, personal-injury attorneys, patients, and other parties • Evaluate settlement proposals and develop counteroffers and settlement recommendations • Negotiate resolutions within assigned authority and escalate matters requiring approval • Research and resolve disputed, delayed, underpaid, denied, high-dollar, and complex accounts • Review payments, adjustments, account balances, settlement activity, and account disposition for accurate final resolution • Identify and escalate financial, compliance, lien, documentation, or recovery risks • Maintain detailed documentation of investigations, negotiations, settlement decisions, lien actions, and resolutions • Use EHR, payer and carrier resources, client systems, legal documentation, and Revco account-management systems • Maintain compliance with HIPAA, regulatory requirements, client requirements, and company policies • Serve as a resource to Level I Specialists • Assist leadership with training, workflow development, reference materials, templates, and best practices • Identify recovery barriers and process gaps and recommend reimbursement improvements to leadership • Support escalated accounts, special projects, client initiatives, and other management assignments

🎯 Exigences

• 3–5+ years of experience in MVA/TPL, bodily injury claims, subrogation, medical lien resolution, complex healthcare reimbursement, or a closely related liability-claims environment • Direct hospital or provider-side revenue cycle experience strongly preferred • Experience independently investigating accident-related claims and identifying available insurance coverage and other sources of reimbursement • Experience communicating and negotiating with liability insurance carriers, claims adjusters, attorneys, and other external parties • Working knowledge of hospital liens and lien-related reimbursement processes • Experience preparing, submitting, monitoring, and resolving hospital liens strongly preferred • California MVA/TPL and California hospital lien experience strongly preferred • Strong understanding of healthcare billing, account balances, claims, payments, adjustments, denials, and reimbursement processes • Ability to independently analyze complex accounts and develop appropriate resolution strategies • Strong negotiation, critical-thinking, problem-solving, and decision-making skills • Ability to evaluate settlement proposals and develop supported recommendations • Strong written and verbal communication skills • Ability to manage complex, high-priority accounts with varying deadlines and resolution requirements • EPIC, Cerner, Meditech, CRXIS, or comparable patient accounting/account-management system experience preferred but not required • Healthcare revenue-cycle, claims, insurance, or liability-related certifications are a plus but not required

🏖️ Avantages

• Equal employment opportunity commitment • Reasonable accommodations for qualified individuals with disabilities and applicants with pregnancy, childbirth, or related medical-condition limitations