Recovery Specialist
About The Position
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. The Recovery Specialist is responsible for the identification and research of third party claims. Works for the recovery of overpayments involving workers compensation, no-fault, hospital liens, and any other type of accident or liability claims. Identifies legal liability, and pursues, negotiates, and settles subrogation, liens, and reimbursement recoveries. Job Description Applies applicable laws, regulations, and policy language to achieve recoveries in accordance to mandates. Negotiates lien settlements with attorneys and other responsible representatives to obtain maximum recovery. Assists in response to Summons and Complaint and interrogatories from attorneys where suit has been commenced. Communicates legal rights to all involved parties placing them on notice of lien. Reviews medical charges to identify relatedness. Maintains detailed recovery records to ensure case facts are accurate. Maintains a high level of technical skill and knowledge of recovery processes to act as a resource to the department. Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions.
Requirements
- Associates degree in business, legal, or healthcare related field required. In lieu of education leadership may accept three years’ applicable work experience.
- Minimum of one year work experience with coding, insurance processes, liability, subrogation, coordination of benefits or workers' compensation claim adjudication.
Nice To Haves
- CSRP (Certified Subrogation Recovery Professional) designation from NASP (National Association of Subrogation Professionals) preferred.
Responsibilities
- identification and research of third party claims
- recovery of overpayments involving workers compensation, no-fault, hospital liens, and any other type of accident or liability claims
- Identifies legal liability, and pursues, negotiates, and settles subrogation, liens, and reimbursement recoveries
- Applies applicable laws, regulations, and policy language to achieve recoveries in accordance to mandates
- Negotiates lien settlements with attorneys and other responsible representatives to obtain maximum recovery
- Assists in response to Summons and Complaint and interrogatories from attorneys where suit has been commenced
- Communicates legal rights to all involved parties placing them on notice of lien
- Reviews medical charges to identify relatedness
- Maintains detailed recovery records to ensure case facts are accurate
- Maintains a high level of technical skill and knowledge of recovery processes to act as a resource to the department
- Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions
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What This Job Offers
Job Type
Full-time
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
