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Carrot Peelers, Sales, Personality and Your Job Search
In-House
Legal Staff
Health Care
Min 2 yrs required
Paralegal The candidate will Must be accountable for managing the coordination of claim payments among health plans and other responsible parties through negotiations for a successful recovery of 1st and 3rd party funds. Responsibilities include managing a “paperless” healthcare subrogation case load through investigation, pending and settlement stages of the recovery process. Will identify and develop complex subrogation recovery/settlement opportunities following client specific policies, procedures and guidelines and negotiate settlements in the best interest of those clients and Discovery Health Partners. Continuously research and request case information or status to drive cases to resolution. Maintain detailed and accurate case records and calendar diaries to monitor case activities to meet department expectations. Respond timely to all electronic, written and verbal communications within a defined deadline. Access and retrieve benefit detail from clients’ remote health claim systems. Collaborate with the legal team and management to proactively resolve cases. Ensure compliance of all state and federal laws. Maintain department recovery, productivity and quality standards. Act as a mentor for newly hired Recovery Analyst and/or other new hires to the department. Participation in department-wide training initiatives/education. Provide feedback to management on trends or developments. Comply with HIPAA regulations as well as Discovery’s HIPAA and Information Security policies and procedures, including required training and incident reporting.
Qualification and Experience
The candidate should have Associate degree, preferably legal studies or paralegal studies. Must have 2+ years of experience in health, disability or P&C insurance. Must have working knowledge of Microsoft Office and internet research skills. Should have experience in the health insurance/personal injury fields and proven experience with managing a mixed case load including workers compensation, third party liability, medical payment, personal injury protection, under insured motorist/uninsured motorist and no-fault coverages. Prior subrogation and negotiation experience is required. Must have proven negotiation experience, specifically in the capacity of persuading and influencing others; ability to negotiate fair settlement consistent with the prevailing subrogation law. Should preferably understand basic health plan contractual provisions and apply to reimbursement efforts. Paralegal Certificate is preferred.
Tracking Code 580-124
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