Report this job

---

What is the problem? *

Incorrect company
Incorrect location
Job is expired
Job may be a scam
Other

We are seeking a talented individual for a Sr Subrogation Case Worker who is responsible for processing all estate functions involving state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes intake, maintenance, claims review and selection, management, settlement and other related functions to the case.
Essential Responsibilities Effectively work, maintain and manage a variety of cases with accurate documentation from case creation to recovery Maintain a daily system of providing timely and accurate information required to move cases through the case management workflow. Confirm documentation of eligibility for beneficiaries by looking up State provided sources Conduct all case document review and updates as needed, based on additional information received throughout the life of the case Confirm and validate third party liability and probate and beneficiary asset research, by utilizing HMS tools and systems Interact professionally (i.e. on incoming and outgoing calls and correspondence) with attorneys, insurance adjusters, medical providers, court staff, recipients and family members Prepare required correspondence about liens, claims and other related documents necessary to progress the case to recovery. Negotiate and compromise claim/lien settlement amounts per contract guidelines. Process all claim/lien disputes and review claims with attorneys and other stakeholders. Conduct outgoing periodic follow up on case status and payment, per contract guidelines Perform basic and advanced levels of document review to identify current case status, legal research, and case management and ensure case progress through workflow. Prioritize case events and critical case payment/recovery issues, while meeting, various internal and legal deadlines that are revenue impacting. Compile, analyze and make conclusions about case information and status from multiple sources. Meet department objective standards for Customer Service. Complete periodic reports for management. Ensure all processes meet HIPAA and Government security requirements with regards to sharing/storage/PHI (Personal Health Information). May serve as an escalation point for project team. May have some training responsibilities limited to projects and specific tasks.
Non-Essential Responsibilities Performs other functions as assignedQualifications - InternalKnowledge, Skills and Abilities Ability to interact with all levels of people both internally and externally in a professional manner. Ability to be careful and thorough about detail including with cite-checking and proof-reading skills. Ability to multi-task and prioritize effectively. Ability to work proficiently with Microsoft Office, PowerPoint, Word, and Excel required Ability to work independently to meet objectives. Ability to analyze information and use logic to address work-related issues and problems. Ability to perform presentations with good quality. Ability to perform well in team environment, to achieve business goals. Ability to maintain a high level of confidentiality and ethics. Ability to handle pressure and manage deadline oriented project demands and multiple initiatives.
Work Conditions and Physical Demands Primarily sedentary work in a general office environment Ability to communicate and exchange information Ability to comprehend and interpret documents and data Requires occasional standing, walking, lifting, and moving objects (up to 30 lbs.) Requires manual dexterity to use computer, telephone and peripherals May be required to work extended hours for special business needs May be required to travel at least 10% of time based on business needs
Minimum Education High School Diploma or GED required Education in Legal Studies required, Associates degree required, Bachelor s in legal studies preferred.Certifications Paralegal certificate desiredMinimum Related Work Experience High School Diploma or GED required Education in Legal Studies desired, Associates degree required, Bachelor s in legal studies preferred.Nothing in this job description restricts management s right to assign or reassign duties and responsibilities to this job at any time.