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 applicable laws, regulations, and policy language to achieve recoveries in accordance with mandates. Responsibilities include negotiating lien settlements with attorneys and other responsible representatives, assisting with responses to legal documents when suits have been commenced, communicating lien rights to involved parties, reviewing medical charges for relatedness, and maintaining accurate recovery records. The role also maintains technical knowledge of recovery processes and fulfills ongoing competency requirements.
Requirements
- Associate degree in a business, legal, or healthcare-related field, or three years of applicable work experience in lieu of education.
- At least one year of work experience with coding, insurance processes, liability, subrogation, coordination of benefits, or workers’ compensation claim adjudication.
Nice To Haves
- Certified Subrogation Recovery Professional (CSRP) designation from the National Association of Subrogation Professionals (NASP).
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 with responses to summonses, complaints, and interrogatories from attorneys when a suit has been commenced.
- Communicate legal rights to involved parties and place them on notice of liens.
- Review medical charges to identify relatedness.
- Maintain detailed recovery records and ensure case facts are accurate.
- Maintain technical skill and knowledge of recovery processes to serve as a department resource.
- Meet ongoing competency requirements and maintain the skills, knowledge, and abilities needed to perform role-specific functions within scope.
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
