TPL Caseworker - Little Rock, AR - Onsite

Gainwell•Little Rock, AR

10d•Onsite

About The Position

The TPL Caseworker reviews assigned Medicaid Third Party Liability (TPL) cases and investigates potential sources for recovery of medical assistance funds. The role researches claim histories, insurance information, medical records, computer files, and supporting documentation to determine claim amounts and appropriate next steps. The caseworker communicates with attorneys, insurance companies, Medicaid clients, providers, and other parties to obtain information and move cases toward resolution. The position creates, updates, and maintains accurate electronic and paper case files, including correspondence, narratives, insurance information, and supporting documentation. Assigned cases must be completed accurately and efficiently while meeting established expectations for quality, productivity, timeliness, and case completion. This is a full-time, hourly, non-exempt, onsite position at the Arkansas Department of Human Services, 700 Main Street, Little Rock, Arkansas. The current business schedule is Monday through Friday, 8:00 AM–4:30 PM or 8:30 AM–5:00 PM. Gainwell provides the equipment, systems, and training needed for the position. The role supports a production-focused environment in which accuracy, quality, case volume, timely completion, and professional customer service are important. Video cameras are required for all interviews and during the first week of orientation.

Requirements

Experience in healthcare, medical insurance, Medicaid, claims, case management, collections/recovery, subrogation, legal-medical work, or a related field.
Strong analytical and investigative skills, including the ability to research multiple sources and identify relevant information.
Strong written and verbal communication skills.
Attention to detail, organization, follow-up, and problem-solving ability.
Proficiency with Microsoft Office and multiple computer systems, and the ability to learn new applications and processes quickly.

Nice To Haves

Experience reviewing, researching, or managing medical, insurance, legal, or claims-related cases is strongly preferred.

Responsibilities

Review assigned Medicaid Third Party Liability (TPL) cases and investigate potential sources for recovery of medical assistance funds.
Research claim histories, insurance information, medical records, computer files, and supporting documentation to determine claim amounts and appropriate next steps.
Communicate with attorneys, insurance companies, Medicaid clients, providers, and other parties to obtain information and help move cases toward resolution.
Create, update, and maintain accurate electronic and paper case files, including correspondence, narratives, insurance information, and supporting documentation.
Complete assigned cases accurately and efficiently while meeting established expectations for quality, productivity, timeliness, and case completion.