[Hiring] Senior Recovery Specialist @Sanford Health

Role Description

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.

Company Description

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.