Subrogation Recovery Specialist

Job not on LinkedIn

🔥 3 minutes ago

🇺🇸 United States – Remote

💵 $19 - $21 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Cotiviti

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Cotiviti is a healthcare technology and analytics company that specializes in improving payment accuracy and performance through advanced data analytics solutions. They partner with health plans, government agencies, and healthcare providers to deliver insights that enhance quality and efficiency in care delivery. With solutions such as risk adjustment, payment policy management, and member engagement, Cotiviti aims to optimize financial and clinical outcomes for the healthcare ecosystem.

📋 Description

• Analyze and recover funds related to accidents, injuries, or illnesses where another party is responsible • Work with attorneys, health carriers, adjusters, and other stakeholders to accelerate and maximize settlements • Manage cases from creation through recovery with current and accurate notes • Provide timely and accurate information to move cases through workflow • Confirm beneficiary eligibility documentation • Review and update case documents • Confirm and validate third-party liability, probate, and beneficiary asset research • Interact professionally with attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and clients • Prepare correspondence, liens, claims, and related recovery documents • Negotiate and compromise claim/lien settlement amounts according to contract guidelines • Process claim/lien disputes and review claims with attorneys and stakeholders • Follow up periodically on case status and payments • Perform document review, legal research, and case management • Prioritize case events and payment/recovery issues while meeting internal and legal deadlines • Compile and analyze case information from multiple sources and draw conclusions • Meet department customer service standards • Complete periodic management reports • Ensure processes comply with HIPAA and government security requirements for PHI • Serve as an escalation point for the project team when needed • Support project-specific training responsibilities • Develop training templates, application training, training materials, and user job aids • Coordinate with product teams to keep training materials current • Complete performance-review responsibilities, special projects, and other assigned duties

🎯 Requirements

• High School Diploma or GED required • 3+ years relevant experience • Experience in a Legal office is a plus; paralegal or legal assistant and/or casualty or health insurance experience • Proficiency in Microsoft Excel and Word required • Basic computer proficiency, including typing and navigating various websites • Ability to analyze information and use logic to address work-related issues, problems, or opportunities • Ability to perform presentations with good quality • Ability to work independently to meet objectives • Ability to perform well in a team environment • Strong verbal and written communication skills • Ability to be thorough and detailed • Ability to interact professionally with internal and external stakeholders • Working knowledge of HIPAA privacy and security rules • Ability to maintain confidentiality and ethics • Working knowledge of the subrogation industry required • Ability to interpret an Explanation of Benefits (EOB), UB-04, Form 5500, Summary Plan Description (SPD), Master Plan Document (MPD), and Evidence of Coverage (EOC) preferred • Medicaid and/or Medicare knowledge preferred • Ability to organize information for required parties • Ability to handle pressure, deadline-oriented project demands, and multitask on a caseload • Bilingual Spanish and English is a plus • Must be able to provide a dedicated, secure work area • Must be able to provide high-speed internet access/connectivity and office setup and maintenance • Must be able to perform duties with or without reasonable accommodation

🏖️ Benefits

• Discretionary bonus consideration • Overtime pay for hours worked in excess of 40 hours per week, or as required by applicable state law • Medical insurance • Dental insurance • Vision insurance • Disability insurance • Life insurance • 401(k) savings plan • Paid family leave • 9 paid holidays per year • 17-27 days of Paid Time Off (PTO) per year, depending on level and length of service