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Healthcare Recovery Investigator The candidate will handle a steady volume of new referrals daily. Will understand concepts of coverage, policy interpretation and liability determination to analyze and move claims towards resolutions. Research applicability of laws, regulations and other requirements to cases. Ensure compliance with Health Insurance Portability and Accountability Act. Validate claim liability, adjuster's contact information, claim status, availability of coverage and accident - related injuries. Focus will be on speed and quality of contacts, investigations and evaluations. Research and analyze information gathered through investigation. Thoroughly document all written and verbal communications. Assist with training and mentoring for other Subrogation staff as needed. Must have a High School Diploma / GED (or higher). Should have 1+ years of alpha-numeric data entry experience. Associate's Degree (or higher) in Paralegal Studies or in a Business-related area is a plus. Understanding of subrogation principles, health insurance and / or P&C insurance is preferred. Should preferably have knowledge of local, state and federal laws and regulations pertaining to insurance. Ability to create and edit letters with Microsoft Word is a plus. Ability to create and modify spreadsheets Microsoft Excel is preferred.
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