Recovery Specialist
About The Position
The Recovery Specialist identifies and researches third-party claims and works to recover overpayments involving workers' compensation, no-fault claims, hospital liens, and other accident or liability claims. The role identifies legal liability and pursues, negotiates, and settles subrogation, lien, and reimbursement recoveries. The specialist applies relevant laws, regulations, and policy language to achieve recoveries in accordance with applicable mandates. They negotiate lien settlements with attorneys and other responsible representatives to obtain maximum recovery, assist with responses to legal documents when suits have been commenced, communicate lien rights to involved parties, and review medical charges for relatedness. The role also maintains detailed recovery records and technical knowledge of recovery processes, serves as a resource to the department, and meets ongoing competency requirements.
Requirements
- Associate degree in business, legal, or a healthcare-related field, or three years of applicable work experience in lieu of education, as accepted by leadership.
- At least one year of work experience with coding, insurance processes, liability, subrogation, coordination of benefits, or workers' compensation claim adjudication.
Nice To Haves
- CSRP (Certified Subrogation Recovery Professional) designation from NASP (National Association of Subrogation Professionals).
Responsibilities
- Identify and research third-party claims.
- Recover overpayments involving workers' compensation, no-fault claims, hospital liens, and other accident or liability claims.
- Identify legal liability and pursue, negotiate, and settle subrogation, lien, and reimbursement recoveries.
- Apply applicable laws, regulations, and policy language to achieve recoveries in accordance with mandates.
- Negotiate lien settlements with attorneys and other responsible representatives to obtain maximum recovery.
- Assist in responding to Summons and Complaint and interrogatories from attorneys when a suit has been commenced.
- Communicate legal rights to involved parties and place them on notice of a lien.
- Review medical charges to identify relatedness.
- Maintain detailed recovery records to ensure case facts are accurate.
- Maintain technical skill and knowledge of recovery processes and act as a departmental resource.
- Meet ongoing competency requirements for role-specific functions.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
