Senior Subrogation & Medicaid Claims Specialist

Gainwell Technologies LLC; United States; Hybrid; USD 25,000 - 35,000; Full time

Benefits offered by this job

Generous, flexible vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Leadership and technical development

Job summary

Gainwell Technologies seeks a Senior Subrogation Case Worker to handle probate and estate matters for Medicaid beneficiaries, including intake, review, asset research, and court filings. You will manage hundreds of cases, coordinating with attorneys, providers, and families while ensuring HIPAA compliance and timely milestones.

The role supports telework or hybrid work with a focus on security and productivity, requiring strong analytical skills and careful document handling.

Qualifications

• 2+ years of relevant professional experience in subrogation, claims, or case management.
• Proficiency in Microsoft Word and Excel; basic knowledge of Microsoft Access is preferred.
• Experience in a legal or insurance office setting (paralegal, legal assistant, casualty, or health insurance experience preferred).
• Familiarity with Medicaid and/or Medicare programs is preferred.

Responsibilities

• Ensure all processes meet HIPAA and Government security requirements with regards to sharing/storage/PHI (Personal Health Information).
• Utilize complex analytical skills to manage subrogation cases, notate files and negotiate settlements on 700 to 1,000 cases at a time.
• Interact professionally, primarily using incoming and outgoing calls, with attorneys, insurance adjusters, medical providers, court staff, recipients and family members, and clients.
• Prepare required correspondence, liens, claims, and other related documents to progress the case to recovery.
• Meet department objective standards for Customer Service, settlement goals, and file handling 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.
• Confirm documentation of eligibility for beneficiaries.
• Conduct all case document review and updates as needed.
• Confirm and validate third party liability, probate, and beneficiary asset research.
• Compile, analyze, and make conclusions about case information and status from multiple sources.
• Process all claim/lien disputes and review claims with attorneys and other stakeholders.
• Conduct outgoing periodic follow up on case status and payment.
• Negotiate and compromise claim/lien settlement amounts per contract guidelines.
• Sign and file notarized documents with counties on applicable cases.
• Prioritize case events and critical case payment/recovery issues, while meeting various internal and legal deadlines that are revenue impacting.
• Meet file handling and phone call metrics related to each case

Skills

Subrogation/case management

MS Word

MS Excel

Legal/insurance office experience

Medicaid/Medicare familiarity

Tools

Microsoft Access

Job description

Gainwell Technologies seeks a Senior Subrogation Case Worker to handle probate and estate matters for Medicaid beneficiaries, including intake, review, asset research, and court filings. You will manage hundreds of cases, coordinating with attorneys, providers, and families while ensuring HIPAA compliance and timely milestones.

The role supports telework or hybrid work with a focus on security and productivity, requiring strong analytical skills and careful document handling.