Recovery Specialist

10000 Sanford; Wisconsin; Hybrid; USD 25,000 - 40,000; Full time

Job summary

Sanford Health is seeking a Recovery Specialist to identify and research third party claims and pursue subrogation recoveries across workers' compensation, hospital liens, and related liability cases. You will negotiate settlements with attorneys, review medical charges for relevance, and maintain detailed case records to support recoveries.

The role requires an associates degree in a related field or three years of equivalent experience, with a CSRP designation preferred; a talent for precise

Qualifications

• Minimum of one year work experience with coding, insurance processes, liability, subrogation, coordination of benefits or workers' compensation claim adjudication.

Responsibilities

• 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.

Skills

Subrogation experience

Education

Associates degree in business, legal, or healthcare related field

CSRP certification (NASP)

Job description

Work Shift

Work Shift: 8 Hours - Day Shifts (United States of America) Scheduled Weekly Hours: 40 Compensation: Salary Range: $18.00 - $29.00 Union Position: No

Department Details Summary

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.

Qualifications

• 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.
• CSRP (Certified Subrogation Recovery Professional) designation from NASP (National Association of Subrogation Professionals) preferred.

Sanford is an EEO/AA Employer M/F/Disability/Vet.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to [e-mail].

The Sanford organization owns and manages multiple distinct brands, including Sanford Health, Marshfield Clinic, and Good Samaritan, as well as Lewis Drug, Sanford Health Equip, Solutions by Sanford, Great Shots, and Blue Rock Bar & Grill.

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland.

Headquartered in Sioux Falls, South Dakota, the organization has 53,000 employees and serves over 2 million patients and nearly 425,000 health plan members across the upper Midwest including South Dakota, North Dakota, Minnesota, Wyoming, Iowa, Wisconsin and the Upper Peninsula of Michigan.

The integrated nonprofit health system includes a network of 56 hospitals, 288 clinic locations, 147 senior care communities, 4,000 physicians and advanced practice providers and nearly 1,500 active clinical trials and studies.

The organization’s transformational virtual care initiative brings patients closer to care with access to 78 specialties.

Learn more about Sanford Health’s commitment to shaping the future of rural health care across the lifespan at sanfordhealth.org or Sanford Health News.

Good Samaritan, one of the nation’s largest nonprofit providers of senior care and services, is committed to transforming the aging experience through innovation, compassion and personalized care.

As part of Sanford Health, an integrated nonprofit health system headquartered in Sioux Falls, South Dakota, Good Samaritan serves 10,000 seniors and offers access to a full continuum of care, including 94 rehabilitation and skilled nursing centers, 56 assisted living and memory care facilities, 44 independent living locations and 37 home health and hospice agencies.

The senior care provider delivers services across the upper Midwest, with 70% of residents living in rural communities.

Learn more about Good Samaritan’s mission and commitment to delivering high quality senior care in rural America at good-sam.com.