Recovery Specialist

🔥 0 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $18 - $29 / hour

⏰ Full Time

🟢 Junior

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Sanford Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1894

⚕️ Healthcare Insurance

Healthcare Insurance

Sanford Health is the largest rural health system in the United States, dedicated to transforming the healthcare experience and providing access to world-class healthcare in America's heartland. Headquartered in Sioux Falls, South Dakota, Sanford Health serves over 1. 4 million patients and nearly 200,000 health plan members across 250,000 square miles. The integrated health system includes 48 medical centers, 211 clinic locations, and more than 160 senior living centers, employing 2,900 physicians and advanced practice providers. Sanford Health is committed to offering compassionate care through its Centers of Excellence, focusing on specialties such as cancer, orthopedics, women’s health, and genetics. Additionally, it provides affordable health insurance, engages in extensive clinical trials, and supports personalized genetic medicine.

📋 Description

• The Recovery Specialist is responsible for the identification and research of third party claims. • Works for the recovery of overpayments involving workers compensation, no-fault, hospital liens, and any other type of accident or liability claims. • Identifies legal liability, and pursues, negotiates, and settles subrogation, liens, and reimbursement recoveries. • Applies applicable laws, regulations, and policy language to achieve recoveries in accordance to mandates. • Negotiates lien settlements with attorneys and other responsible representatives to obtain maximum recovery. • Assists in response to Summons and Complaint and interrogatories from attorneys where suit has been commenced. • Communicates legal rights to all involved parties placing them on notice of lien. • Reviews medical charges to identify relatedness. • Maintains detailed recovery records to ensure case facts are accurate. • Maintains a high level of technical skill and knowledge of recovery processes to act as a resource to the department. • Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions.

🎯 Requirements

• Associates degree in business, legal, or healthcare related field required. • In lieu of education leadership may accept three years’ applicable work experience. • Minimum of one year work experience with coding, insurance processes, liability, subrogation, coordination of benefits or workers' compensation claim adjudication. • CSRP (Certified Subrogation Recovery Professional) designation from NASP (National Association of Subrogation Professionals) preferred.