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Senior Subrogation Caseworker The candidate will process all casualty or estate functions involving several state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes intake, maintenance, claims review and selection, management, settlement and other related functions to the case. 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 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. High school diploma or GED required. Education in Legal Studies required. Associate's degree required. Bachelor's in legal studies preferred. Paralegal certificate desired. Ability to work proficiently with MS Office, PowerPoint, Word, and Excel required.
Ref. #: 1800107C
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