Subrogation Specialist

at MultiPlan in Naperville, Illinois, United States

Job Description

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.
Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!
Process a paperless health insurance subrogation caseload by investigating and developing subrogation case facts and sources of recovery. Responsibilities include placing a large volume of outbound calls as well as submitting correspondence to health plan members, insurance companies, and attorney offices. The Discovery Health Partners work environment is team-orientated. The Subrogation Specialist will coordinate efforts with other members of the subrogation team to maximize recovery in accordance with Subrogation Policies and Procedures.
JOB ROLES AND RESPONSIBILITIES:

1. Learn and understand fundamentals of health insurance subrogation, including basic health plan contractual provisions that apply to the reimbursement efforts
2. Review, Identify and develop subrogation opportunities by gathering missing information and potential sources of recovery
3. Place parties of interest on notice
4. Organize and structure investigations to work in priority order using the tools provided
5. Respond timely to all electronic, written and verbal communications
6. Log and maintain detailed and accurate records
7. Access and pull benefits from clients' health claim systems
8. Engage advice and/or help of legal manager to proactively resolve cases
9. Ensure compliance of state and federal laws
10. Provide feedback to management and unit on trends or developments
11. Collaborate, coordinate, and communicate across disciplines and departments.
12. Ensure compliance with HIPAA regulations and requirements.
13. Demonstrate Company's Core Competencies and values held within.
14. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
15. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
JOB SCOPE:
Performs role under direct supervison, decision making is limited in scope, follows defined structure and must be escalated if outside of scope. Must collaborate across team. Must interact with customers/clients on a regular basis and keep the needs of external and internal customers as a priority when making decisions and taking action. Must meet quality and productivity standards.

The salary range for this position is $18-$19 an hour. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

As an Equal Opportunity Employer, the Company will provide equal consideration to all employees and job candidates without regard to sex, age, race, marital status, sexual orientation, religion, national origin, citizenship status, physical or mental disability, political affiliation, service in the Armed Forces of the United States, or any other characteristic protected by federal, state, or local law.  Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled