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Medical Claims Recovery Specialist (Subrogation) - Georgia
Tucker, GA$44K - $54K / yearPosted 1 weeks ago
Full-timehybridmid
Job Description
Your role in our mission
• Provide enrollment support and HIPP/Premium Assistance program information to Medicaid-eligible individuals and their families via phone.
• Verify, document, and investigate healthcare coverage for Medicaid recipients and their dependents.
• Identify members who may qualify for the HIPP/Premium Assistance program.
• Complete periodic and ad-hoc reports as required.
• Handle high-volume customer service calls, including inquiries about the HIPP/Premium Assistance program.
• Perform accurate and timely data entry.
• Obtain and/or verify all documentation required for eligibility and enrollment into the HIPP/Premium Assistance program.
• Maintain active cases during open enrollment and premium review periods to support revenue and program growth.
• Independently manage a variety of cases of differing complexity within established service level agreements.
• Conduct outgoing follow-up calls regarding case status, payments, or outstanding requirements.
• Perform advanced document review, case status identification, basic legal research, and escalate issues when necessary.
• Prioritize and manage all case events and critical payment/recovery tasks while meeting internal and regulatory deadlines.
• Interact professionally with attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and internal clients.
• Provide enrollment support and HIPP/Premium Assistance program information to Medicaid-eligible individuals and their families via phone.
• Verify, document, and investigate healthcare coverage for Medicaid recipients and their dependents.
• Identify members who may qualify for the HIPP/Premium Assistance program.
• Complete periodic and ad-hoc reports as required.
• Handle high-volume customer service calls, including inquiries about the HIPP/Premium Assistance program.
• Perform accurate and timely data entry.
• Obtain and/or verify all documentation required for eligibility and enrollment into the HIPP/Premium Assistance program.
• Maintain active cases during open enrollment and premium review periods to support revenue and program growth.
• Independently manage a variety of cases of differing complexity within established service level agreements.
• Conduct outgoing follow-up calls regarding case status, payments, or outstanding requirements.
• Perform advanced document review, case status identification, basic legal research, and escalate issues when necessary.
• Prioritize and manage all case events and critical payment/recovery tasks while meeting internal and regulatory deadlines.
• Interact professionally with attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and internal clients.