Medicaid Third Party Liability (TPL) Specialist - Des Moines, IA

Gainwell Technologies LLC•Des Moines, IA

4d•$24,800 - $35,400•Hybrid

About The Position

As an Medicaid Third Party Liability (TPL) Specialist - Des Moines, IA at Gainwell, you will support healthcare operations by verifying, documenting, and coordinating insurance-related information to drive accurate third-party liability (TPL) recovery efforts. This role focuses on researching and validating insurance coverage, managing correspondence with key stakeholders, and supporting workflows tied to the Iowa Medicaid contract. You will operate in a fast-paced, production- and quality-driven environment while ensuring compliance with established processes and service level agreements.

Requirements

High School Diploma or GED required
2+ years of experience with HMS or 3+ years of experience in a professional office environment
Strong working knowledge of Microsoft Office (Excel, Word, Outlook)
Strong attention to detail with the ability to manage multiple priorities
Ability to analyze information and resolve issues using sound judgment
Effective communication and interpersonal skills

Responsibilities

Research, verify, and document third-party liability (TPL) insurance coverage using multiple systems and data sources
Initiate and manage correspondence between Revenue Collections, insurance carriers, and the Iowa Department of Health and Human Services
Conduct outbound calls to insurance carriers to validate coverage and obtain claim-related information
Process and manage incoming faxes and emails related to TPL insurance verification requests
Maintain accurate and timely documentation within systems such as MMIS and OnBase
Identify opportunities to improve workflows and support increased recovery outcomes
Support project initiatives by compiling, analyzing, and reporting data as needed
Ensure compliance with departmental standards and contractual Service Level Agreements (SLAs)
Prepare and deliver periodic reports and updates to leadership
Perform additional duties as assigned