Claims Recovery Specialist (Subrogation) - Albany, NY - Hybrid

Gainwell Technologies LLC-posted 19 days ago
$35,000 - $50,000/Yr
Full-time • Entry Level
Hybrid
5,001-10,000 employees
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Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. We are seeking a detail-oriented and motivated Subrogation Specialist responsible for managing all casualty and estate-related functions involving state Medicaid beneficiaries and deceased Medicaid beneficiaries. This role encompasses the full case lifecycle, including intake, case maintenance, claims review and selection, case management, settlement negotiations, and all related recovery functions.

  • Ensure full compliance with HIPAA and government security standards regarding the use, storage, and sharing of Personal Health Information (PHI).
  • Manage a high-volume caseload of 700–1,000 subrogation cases, applying strong analytical skills to document case activity, negotiate settlements, and drive recovery results.
  • Communicate professionally with attorneys, insurance adjusters, medical providers, court officials, recipients, family members, and clients, primarily via inbound and outbound calls.
  • Prepare, process, and maintain all required documentation, including correspondence, liens, claims, and related materials.
  • Meet established departmental standards for customer service, settlement performance, and file management.
  • Conduct detailed document reviews, perform legal research, and ensure cases move forward in a timely manner.
  • Verify beneficiary eligibility and maintain accurate case documentation.
  • Confirm and validate third-party liability, probate information, and beneficiary asset data through comprehensive research.
  • Analyze case data from multiple sources to determine status and support informed decision-making.
  • Manage claim and lien disputes in collaboration with attorneys and other stakeholders.
  • Perform regular follow-ups on case status and payment activity.
  • Negotiate and resolve claim and lien amounts according to contractual and regulatory guidelines.
  • Prepare and file notarized legal documents with county offices when required.
  • Prioritize critical deadlines and revenue-impacting events while ensuring compliance with legal and internal timelines.
  • Consistently meet productivity and performance metrics, including caseload volume and call expectations.
  • Demonstrate strong analytical, problem-solving, and organizational skills.
  • Work independently while contributing effectively within a collaborative team environment.
  • Manage ultiple deadlines and priorities in a fast-paced setting.
  • Maintain exceptional attention to detail, including accuracy in documentation, citation, and proofreading.
  • Communicate professionally across all organizational levels and with external partners.
  • Uphold strict confidentiality and ethical standards at all times.
  • High School Diploma or GED required.
  • Minimum of 2 years of relevant experience.
  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) required.
  • Ability to report to the Albany, NY office two (2) times per month for mandatory in-office days, or additionally as needed for document processing.
  • Employees must live within a reasonable commuting distance of the Albany office.
  • Video camera use is required for all interviews and during the initial week of orientation.
  • Teleworkers must maintain a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload (higher speeds recommended).
  • Prior experience in a legal office (paralegal or legal assistant) and/or in the insurance industry (casualty or health) preferred.
  • Knowledge of Medicaid and/or Medicare strongly preferred.
  • Basic knowledge of Microsoft Access preferred.
  • flexible vacation policy
  • 401(k) employer match
  • comprehensive health benefits
  • educational assistance
  • leadership and technical development academies
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