Senior Recovery Specialist

Sanford Health•Remote WI, WI

2d•$19 - $31•Onsite

About The Position

The Senior Recovery Specialist is responsible for the identification and research of third party claims. Works for the recovery of overpayments involving workers compensation, no-fault, hospital liens, and any other type of accident or liability claims. Identifies legal liability, and pursues, negotiates, and settles subrogation, liens, and reimbursement recoveries. The Recovery Specialist-Senior will also be responsible for creating and maintaining department policies/procedures, training new staff, and working special projects for the department. Applies applicable laws, regulations, and policy language to achieve recoveries in accordance to mandates. Negotiates lien settlements with attorneys and other responsible representatives to obtain maximum recovery. Assists in response to Summons and Complaint and interrogatories from attorneys where suit has been commenced. Communicates legal rights to all involved parties placing them on notice of lien. Reviews medical charges to identify relatedness. Maintains detailed recovery records to ensure case facts are accurate. Maintains a high level of technical skill and knowledge of recovery processes to act as a resource to the department. Mentors Recovery Specialist to ensure completion of efficient and accurate litigation process. Trains new staff to ensure high quality job skills and expertise. Develops and maintains subrogation departmental procedures to ensure staff have accurate, thorough, and current position resources. Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions.

Requirements

Associates degree in business, legal, or healthcare related field required. In lieu of education leadership may accept six years’ applicable work experience.
Minimum of three years’ 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) preferred.

Responsibilities

Identification and research of third party claims.
Recovery of overpayments involving workers compensation, no-fault, hospital liens, and any other type of accident or liability claims.
Identifying legal liability, and pursuing, negotiating, and settling subrogation, liens, and reimbursement recoveries.
Creating and maintaining department policies/procedures.
Training new staff.
Working special projects for the department.
Applying applicable laws, regulations, and policy language to achieve recoveries in accordance to mandates.
Negotiating lien settlements with attorneys and other responsible representatives to obtain maximum recovery.
Assisting in response to Summons and Complaint and interrogatories from attorneys where suit has been commenced.
Communicating legal rights to all involved parties placing them on notice of lien.
Reviewing medical charges to identify relatedness.
Maintaining detailed recovery records to ensure case facts are accurate.
Maintaining a high level of technical skill and knowledge of recovery processes to act as a resource to the department.
Mentoring Recovery Specialists to ensure completion of efficient and accurate litigation process.
Developing and maintaining subrogation departmental procedures to ensure staff have accurate, thorough, and current position resources.
Reviewing and meeting ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions.