Senior Recovery Specialist

Good Samaritan Society; Northern (KY); Hybrid; USD 26,000 - 41,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Life insurance

401(k) retirement plan

Work/life balance benefits

Generous time off

Job summary

Sanford Health is seeking a Senior Recovery Specialist to identify and research third-party claims for recovery of overpayments, including workers' compensation and other liability liens. The role requires negotiating settlements and assisting with litigation, while developing department policies and mentoring staff.

Responsibilities include guiding recovery processes, ensuring compliance with applicable laws, and maintaining detailed case records.

Qualifications

• Associate degree or six years’ related work experience.
• 3+ years in coding, insurance, liability or workers' comp adjudication.
• CSRP from NASP preferred.

Responsibilities

• Identify and research third-party claims for recovery of overpayments.
• Negotiate and settle subrogation, liens, and reimbursements per regulations.
• Create and maintain department policies and train staff.
• Assist with litigation responses and respond to inquiries from attorneys.

Skills

Subrogation

Insurance processes

Legal knowledge

Communication

Education

Associate degree in business/legal/healthcare

Job description

Careers With Purpose

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.

Facility: Remote WI
Location: Remote, WI
Address:
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $19.00 - $30.50

Job Summary

The Senior 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. The Recovery Specialist-Senior will also be responsible for creating and maintaining department policies/procedures, training new staff, and working special projects for the department. 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.

Mentors Recovery Specialist to ensure completion of efficient and accurate litigation process. Trains new staff to ensure high quality job skills and expertise.

Develops and maintains subrogation departmental procedures to ensure staff have accurate, thorough, and current position resources. 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 six years’ applicable work experience.

Minimum of three years’ 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.

Benefits

Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

• health insurance
• dental insurance
• vision insurance
• life insurance
• a 401(k) retirement plan
• work/life balance benefits
• a generous time off package to maintain a healthy home-work balance

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 1-877-673-0854 or send an email to [e-mail] .

Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0275140
Job Function: Legal and Compliance
Featured: No