Case Development Specialist

Intellivo•Creve Coeur, MO

About The Position

The Case Development Specialist is responsible for identifying and validating potential subrogation and reimbursement opportunities for Intellivo’s clients. This role reviews medical claims, property & casualty (P&C) data, and related information to determine whether recovery potential exists and ensures viable cases are accurately set up for downstream teams. The Case Development Specialist serves as a critical quality and triage function—confirming case validity, clarifying key facts, and improving the accuracy and value of the subrogation pipeline.

Requirements

1–3 years of experience in a data-heavy environment such as claims, billing, insurance operations, revenue cycle, or similar administrative/analytic roles
Strong attention to detail and ability to maintain focus while reviewing large volumes of information
Solid analytical and pattern-recognition skills; able to apply rules and criteria consistently and spot outliers or inconsistencies
Excellent computer skills, including comfort working across multiple systems and screens
Proficiency with Microsoft Office products, especially Outlook, Word, and Excel
Ability to work both independently and in a team setting, asking questions and escalating when needed
Strong organization and time management; able to manage queues and meet throughput and quality expectations
Flexibility and comfort working in a fast-paced, changing environment

Nice To Haves

Associate's or Bachelor's degree preferred but not required; equivalent experience considered
Experience working with healthcare claims, P&C data, or subrogation is a plus but not required
Experience with healthcare claims data, P&C databases, or other analytic tools
Prior experience in subrogation, claims, or revenue cycle environments
Experience using case management platforms or rules-based triage/queue systems

Responsibilities

Case Identification & Assessment Review claims data, P&C results, and other inputs to identify events that may give rise to subrogation or reimbursement
Apply established criteria, rules, and playbooks to determine whether a case is appropriate for creation, closure, or further review
Distinguish accident-related and third-party liability scenarios from non-recoverable or low-value situations
Case Setup & Enrichment Create and update cases in designated systems with the appropriate parties, injury/accident information, and key claim details
Capture and summarize core facts so downstream recovery, legal, or reimbursement teams have a clear starting point
Assign case type, priority, and other attributes in accordance with guidelines and client requirements
Information Clarification & Coordination Request and review additional information from carriers, TPAs, attorneys, or internal partners when needed to confirm case validity or clarify discrepancies
Document clarifications and decisions so that the rationale for case disposition (open, close, reclassify) is clear
Coordinate with leaders or subject matter experts on complex or borderline scenarios
Data Quality, Documentation & Throughput Maintain accurate, complete, and well-organized case records, notes, and status fields in all applicable systems
Monitor personal queues and workload to ensure timely review and disposition of cases in line with productivity and quality expectations
Identify and correct data inconsistencies or errors that could impact downstream work or reporting
Collaboration & Continuous Improvement Partner with subrogation leadership and downstream operations teams (recovery, legal, reimbursement) to refine criteria and workflows
Share observations about recurring data issues, false positives, or missed opportunities to inform process or rules improvements
Participate in pilots, testing, and feedback cycles for new clients, data sources, and identification logic