Medical Claims Recovery Specialist (Subrogation) - Little Rock, AR (Onsite)

Gainwell Technologies LLC•Little Rock, AR

52d•Onsite

About The Position

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. SummaryWe are seeking a detail-oriented and driven Subrogation Specialist to manage casualty and estate-related functions for Medicaid beneficiaries, including those who are deceased. This role involves comprehensive case management—from intake and claims review to settlement and recovery—across multiple jurisdictions and stakeholders.Your role in our missionAs a Subrogation Specialist, you will: Ensure all processes comply with HIPAA and government security standards regarding the handling and storage of Protected Health Information (PHI). Manage a high-volume caseload (700–1,000 cases), applying advanced analytical skills to track, notate, and negotiate settlements. Communicate professionally via inbound and outbound calls with attorneys, insurance adjusters, medical providers, court personnel, recipients, family members, and clients. Prepare and process correspondence, liens, claims, and other documentation to support case recovery. Meet departmental standards for customer service, settlement goals, and file handling. Conduct legal research and document reviews to assess case status and ensure workflow progression. Verify beneficiary eligibility and update case documentation as needed. Research and validate third-party liability, probate matters, and beneficiary assets. Analyze case data from multiple sources to determine status and next steps. Handle claim/lien disputes and collaborate with attorneys and stakeholders for resolution. Perform periodic follow-ups on case status and payments. Negotiate and settle claims/liens in accordance with contractual guidelines. Prepare, sign, and file notarized documents with county offices as applicable. Prioritize critical case events and payment/recovery issues while meeting internal and legal deadlines. Maintain performance metrics related to file handling and call volume. Exceptional attention to detail, including cite-checking and proofreading. Ability to manage multiple tasks and prioritize effectively in a fast-paced environment. Demonstrated ability to work independently and meet objectives with minimal supervision. Strong analytical and problem-solving skills. Team-oriented mindset with a commitment to achieving shared business goals. High level of integrity and ability to maintain confidentiality. Capacity to perform under pressure and manage multiple deadline-driven initiatives.

Requirements

Minimum of two (2) years of relevant professional experience.
Proficiency in Microsoft Word and Excel is required; familiarity with PowerPoint and basic knowledge of Microsoft Access is preferred.
Exceptional attention to detail, including cite-checking and proofreading.
Ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
Demonstrated ability to work independently and meet objectives with minimal supervision.
Strong analytical and problem-solving skills.
Team-oriented mindset with a commitment to achieving shared business goals.
High level of integrity and ability to maintain confidentiality.
Capacity to perform under pressure and manage multiple deadline-driven initiatives.

Nice To Haves

Experience in a legal office setting (e.g., paralegal or legal assistant) is preferred. Background in the insurance industry—particularly in casualty or health insurance—is highly desirable.
Working knowledge of Medicaid and/or Medicare is preferred.
Strong interpersonal skills with the ability to interact professionally across all organizational levels and with external stakeholders.

Responsibilities

Ensure all processes comply with HIPAA and government security standards regarding the handling and storage of Protected Health Information (PHI).
Manage a high-volume caseload (700–1,000 cases), applying advanced analytical skills to track, notate, and negotiate settlements.
Communicate professionally via inbound and outbound calls with attorneys, insurance adjusters, medical providers, court personnel, recipients, family members, and clients.
Prepare and process correspondence, liens, claims, and other documentation to support case recovery.
Meet departmental standards for customer service, settlement goals, and file handling.
Conduct legal research and document reviews to assess case status and ensure workflow progression.
Verify beneficiary eligibility and update case documentation as needed.
Research and validate third-party liability, probate matters, and beneficiary assets.
Analyze case data from multiple sources to determine status and next steps.
Handle claim/lien disputes and collaborate with attorneys and stakeholders for resolution.
Perform periodic follow-ups on case status and payments.
Negotiate and settle claims/liens in accordance with contractual guidelines.
Prepare, sign, and file notarized documents with county offices as applicable.
Prioritize critical case events and payment/recovery issues while meeting internal and legal deadlines.
Maintain performance metrics related to file handling and call volume.

Benefits

Health benefits (medical, dental, and vision) begin on Day 1 of employment.
401(k) with company match and additional benefits become available within the first few months.
Employees can take advantage of the flexible vacation policy after 90 days of employment. Any exceptions require manager approval before the employee's start date at Gainwell.
Career growth and advancement opportunities are encouraged and supported.
A company-provided computer is supplied for work use.

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