ORS - Tort Agent

State of Utah Office of the Governor • Taylorsville, UT

2d • Hybrid

About The Position

A Tort Agent uses automated computer systems and associated business practices to verify, investigate, and/or collect from potential third-party payers for the Medicaid program. They provide customer assistance, process legal documents, compile and compose claims/liens or other correspondence, verify potential third-party payers, and any other information affecting collection and/or compliance potential. An agent will explain to customers their responsibilities for payment on a Medicaid lien by telephone, correspondence, or in person.
A Tort Agent will receive payments on accounts, evaluate accounts to verify claims or liens have been filed, review cases for appropriate payment and potential third-party payers, and/or determine appropriate legal action and next steps. They may research, calculate amounts due, and/or prepare documentation for further action. They will gather relevant information through interviews or record searches, analyzing facts, and applying knowledge of agency rules, regulations, and policies, etc.
A Tort Agent may also:
Negotiate settlement of claims.
Work with recipients, attorneys, and insurance companies to pursue debts owed to the State of Utah.
Provide customer service for clients/customers in various state agencies and private companies.
Maintain proficient computer skills in various state systems and online resources.
Reviews Medicaid paid claims information maintained in state computer systems
and using knowledge of state and federal statute and insurance coverage and practices; files appropriate claims to reimburse the Medicaid program.
Maintain accurate computer system accounting records for medical debts to ensure that receipts are posted in accordance with established state business practices.

Requirements

• Proficient research skills.
• Efficient problem solving.
• Good attention to detail.
• Proficiency in a technologically driven environment with intermediate to advanced computer skills.
• Exceptional ability to multi-task and quickly make decisions.
• Strong customer service skills.
• Excellent communication skills with an ability to assist people in a manner which shows sensitivity, tact and professionalism.
• Must successfully pass a criminal history check.

Nice To Haves

• Minimum of 1 year of experience in a medical or legal field.

Responsibilities

• Uses automated computer systems and associated business practices to verify, investigate, and/or collect from potential third-party payers for the Medicaid program.
• Provides customer assistance.
• Processes legal documents.
• Compiles and composes claims/liens or other correspondence.
• Verifies potential third-party payers and any other information affecting collection and/or compliance potential.
• Explains to customers their responsibilities for payment on a Medicaid lien by telephone, correspondence, or in person.
• Receives payments on accounts.
• Evaluates accounts to verify claims or liens have been filed.
• Reviews cases for appropriate payment and potential third-party payers.
• Determines appropriate legal action and next steps.
• Researches, calculates amounts due, and/or prepares documentation for further action.
• Gathers relevant information through interviews or record searches, analyzing facts, and applying knowledge of agency rules, regulations, and policies.
• Negotiates settlement of claims.
• Works with recipients, attorneys, and insurance companies to pursue debts owed to the State of Utah.
• Provides customer service for clients/customers in various state agencies and private companies.
• Maintains proficient computer skills in various state systems and online resources.
• Reviews Medicaid paid claims information maintained in state computer systems and using knowledge of state and federal statute and insurance coverage and practices; files appropriate claims to reimburse the Medicaid program.
• Maintains accurate computer system accounting records for medical debts to ensure that receipts are posted in accordance with established state business practices.

Benefits

• Job Stability: Enjoy the security and reliability of employment within a well-established organization.
• Career Growth: Develop valuable skills and gain opportunities for leadership within a large organization.
• Meaningful Work: Contribute to an important service that benefits the community and supports organizational goals.
• Supportive Work Environment: Be part of a team that values cooperation, strong work ethics, and mutual support.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed