Status: Full-Time permanent position (40 hours)
Standard working hours: 8am to 5pm EST, M-F
Location: Remote in Virginia.
Job Responsibilities:
Scope of position: Facilitates and supports management in the identification and recovery of claim payments for which the plan has, or may have, a right of subrogation to supports the overall objective of reducing medical costs. Processes settlement checks and reconciles funds with Finance and Claims.
Essential job functions:
Receives subrogation mail (including checks) and sort/process it with specific attention to time-sensitive items.
Opens subrogation files electronically and assemble relevant file information about member, injury, paid claims, potential third party liability, and attorney representation.
Conducts investigation and collect supporting documentation to analyze the potential of pursuing collection.
Serves as the key point of contact for receipt, response and/or appropriate distribution of Subrogation Service Forms and for independent individual referrals to the department.
Reviews, compiles, and prepares open cases and data mining letters for the State of Florida audit on a monthly basis.
Enters data into case files, such as documenting communications received by mail, facsimile or telephonically.
Communicates and adheres to requests from third party vendor.
Coordinates with legal counsel.
Performs additional duties and responsibilities as assigned by management
Required qualifications:
HS - High School Grad or Equivalent REQUIRED
Minimum 2 years of experience in Health Plan Claims Disbursmnts REQUIRED
Diversity and Inclusion at Sentara
Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.
We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community. We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.
Our strategies focus on both structural inclusion, which looks at our organizational structures, processes, and practices; as well as behavioral inclusion, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.
Please visit the link below to learn more about Sentara’s commitment to diversity and inclusion:
https://www.sentara.com/aboutus/diversity
Sentara Overview
For more than a decade, Modern Healthcare magazine has ranked Sentara Healthcare as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Healthcare was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:
Medical, Dental, and Vision Insurance
Paid Annual Leave, Sick Leave
Flexible Spending Accounts
Retirement funds with matching contribution
Supplemental insurance policies, including legal, Life Insurance and AD&D among others
Work Perks program including discounted movie and theme park tickets among other great deals
Opportunities for further advancement within our organization
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)
Join our team! We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!
To apply, please go to www.sentaracareers.com and use the following as your Keyword Search: JR-70681.
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Talroo – Health Plan
Managed Care, MCO, Healthcare, Health Plan, Remote, Virginia, Subrogation, Coordinator, Insurance, Claims