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SalaryImagine 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!
This role is accountable for developing cases after the initial investigation to confirm viability of subrogation cases. Moreover, the incumbent manages the coordination of claim payments among health plans, collects refunds of duplicate payments from providers, and successful recovery of 1st party funds. The role provides a final determination on all potential sources of recovery and fully prepares the cases for the Paralegals to successfully negotiate the liability claims. This role requires the incumbent be confident on the phone and comfortable interacting with insurance companies, providers, health plan members, and personal injury attorneys.
JOB ROLES AND RESPONSIBILITIES:
1. Review, identify, and develop subrogation opportunities by gathering missing information and potential sources of recovery. Research and analyze information gathered through continuous investigation. Record and maintain detailed and accurate records.
2. Validate claim viability and terminate pursuit when necessary; respond timely to all electronic, written and verbal communications.
3. Place parties of interest on notice and send subsequent demand letters.
4. Continuously research and make outbound calls to request case information or status to drive cases to be prepared for settlement; maintain detailed and accurate case records and calendar diaries to monitor case activities to meet department expectations.
5. Engage advice and/or help of Negotiators/Paralegals to proactively resolve and/or transfer cases.
6. Ensure compliance of state and federal laws and maintain department productivity and quality standards.
7. Take transferred calls and/or documents from inbound investigation teams to provide a resolution to the enquiry.
8. Collaborate, coordinate, and communicate across disciplines and departments.
9. Ensure compliance with HIPAA regulations and requirements.
10. Demonstrate Company's Core Competencies and values held within.
11. Please note due to the exposure of PHI sensitive data - this role is considered to be a High Risk Role.
12. 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.
2. Validate claim viability and terminate pursuit when necessary; respond timely to all electronic, written and verbal communications.
3. Place parties of interest on notice and send subsequent demand letters.
4. Continuously research and make outbound calls to request case information or status to drive cases to be prepared for settlement; maintain detailed and accurate case records and calendar diaries to monitor case activities to meet department expectations.
5. Engage advice and/or help of Negotiators/Paralegals to proactively resolve and/or transfer cases.
6. Ensure compliance of state and federal laws and maintain department productivity and quality standards.
7. Take transferred calls and/or documents from inbound investigation teams to provide a resolution to the enquiry.
8. Collaborate, coordinate, and communicate across disciplines and departments.
9. Ensure compliance with HIPAA regulations and requirements.
10. Demonstrate Company's Core Competencies and values held within.
11. Please note due to the exposure of PHI sensitive data - this role is considered to be a High Risk Role.
12. 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:
This role keeps the needs of external and internal customers as a priority when making decisions and taking action. The successful incumbent operates independently under limited supervision. This role tasks the incumbent with decision making authority within specified parameters and must engage to obtain advice and/or help of legal manager, negotiator, or paralegal to proactively resolve cases. Works across customers, beneficiaries, providers, and supplemental payors while maintaining positive relationships.
JOB REQUIREMENTS (Education, Experience, and Training):
- Minimum high school diploma coupled with two (2) years' of subrogation, collections, insurance or coordination of benefits (COB) experience. Bachelors' degree in a relevant field in preferred.
- Working knowledge of Microsoft Office and internet research skills
- Working knowledge of Microsoft Office and internet research skills
- Excellent communication skills (both verbal and written).
- Proficient with Microsoft Office and internet research skills.
- Strong organizational and time management skills with the ability to multi-task and work independently.
- Strong analytical, problem solving and decision-making skills; ability to exercise good judgment.
- Must have ability to define problems, collect data, establish facts, and draw valid conclusions.
- Required licensures, professional certifications, and/or Board certifications as applicable
- Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
The salary range for this position is $45 - $48K. 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.
BENEFITS
We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include:
- Medical, dental and vision coverage with low copay & deductible
- Life insurance
- Short and long-term disability
- 401(k) + match
- Generous Paid Time Off
- Paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Summer Hours
The salary range for this position is $45K-$50K. 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 and 401k.
EEO STATEMENT
MultiPlan is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please click here.
