Subrogation Recovery Analyst
If you're looking for a career and not just a job.....
Van Nuys, CA 
Share
Posted 7 days ago
Job Description

The Rawlings Group, founded in 1977, is the premier leader in payment integrity services to the health insurance industry.  Located in La Grange, KY, The Rawlings Group employs 1500 people and is growing.  If you are looking for a great opportunity to make a positive impact on the future of healthcare, The Rawlings Group needs to be your career choice.  

We provide excellent paid classroom training in a supportive environment to ensure you have all the skills and tools necessary to be successful. We are looking for hard-working, talented people who share our commitment to excellence.  Our comprehensive benefit package includes health and dental benefits, short/long term disability plans, 401k with company matching, a generous vacation policy and more. We also offer an onsite gym, cafe and coffee shop.

We are a fast-paced, innovative, technology-driven company.  We offer a unique work environment where you truly can control your own destiny with no limit to earning your monetary goals. We will enable you to achieve your potential and reward you for your efforts. If you thrive in a work environment that allows for independence and offers a variety of challenges please visit our career page on our website, www.rawlingsgroup.com, to find out more about this exciting opportunity.

The compensation package includes a base pay of $50,500 plus significant bonus potential!  An experienced Recovery Analyst averages over $80,000 per year!
 

JOB SUMMARY

The Subrogation Analyst uses complex analytical skills to handle a large volume of subrogation files and ultimately negotiate settlements on behalf of The Rawlings Group's health insurance clients.

ESSENTIAL DUTIES & RESPONSIBILITIES

* Meet the goal of taking 16 inbound calls and making 32 (640/month) outbound calls daily. Maintain 100% quality of 550-700 file count. Maintain tickets daily. Process incoming calls and questionnaires from plan members and patients.

* Determine whether potential subrogation files will be deemed non-recoverable or recoverable. 50%/50% turns in ratio. Meet outbound call goals. Have knowledge and be responsible for specific client bill handing specifications.

* Process subrogation reimbursement files for a potential recovery by investigating and analyzing facts and legal issues developed by contacts with healthcare plan members, insurance adjusters, attorneys, and their staffs. Process incoming calls and questionnaires from plan members and patients.

* Use organizational, analytical, and time management skills to organize daily workflow to maximize client recoveries. Flexibility to adapt to change due to newly exacted statutes, court decisions and policy contract changes. Adjust to company policy and procedural changes.

* Negotiate recoveries with attorneys, insurance adjusters, and members. Develop skills in reviewing and analyzing health plan contracts in relation to individual state laws for recovery right.

* Analyze and understand healthcare contracts. Appropriately identify for medical healthcare liens.

* Flexibility to adapt to change and adjust to company policy and procedural changes.

* Use verbal communication skills by telephone to investigate and gather facts to support recoveries. Use computer processes and software skills to process letters and record activities.  Develop medical expense spreadsheets and process payments from recoveries.

* The ability to work at our Facility and maintain our regular work schedule of Monday through Friday, 8:00 am- 5:00 pm, and the occasional late shift of 11:00 a.m. - 8:00 p.m.

OTHER DUTIES & RESPONSIBILITIES

* Attend ongoing training sessions, team meetings, and gathering with team attorneys to update state by state legal practices.

* Perform other duties as assigned

Requirements

SKILLS & ABILITIES

* Understanding of basic skills (reading, writing, math)

* Strong phone skills, maintenance of records and files, and general office work

* Word processing, office procedures, administrative abilities - minimum typing speed of 30 wpm

* Professional area outside of health care such as negotiations, mortgage lending, collections and sales.

* Experience in the health insurance, legal, property, casualty or related field is preferred

* Places client service as the number one priority.
 

MINIMUM REQUIREMENTS

* Associates Degree

* Bachelor's Degree preferred; Juris Doctorate degree a plus

* Proficiency in written and verbal communications

* Proficient in Microsoft Word, Excel and Outlook

* Multi-tasking skills

* Must be available to attend 10 weeks of paid (including paid expenses) training at our corporate offices in La Grange, Kentucky.

PHYSICAL REQUIREMENTS ESSENTIAL TO PERFORM THE DUTIES OF THE JOB

* Frequently remains in sitting position for long periods of time to perform duties.

* Frequently concentrates for long periods of time, paying close attention to detail.

* Frequently uses and views the computer using fingers, hands, and vision.

* Frequently works in a well-lit, tempered environment.

* Frequently utilizes mental capabilities to identify, evaluate, and assimilate information.

* Seldom lifts objects with weight up to twenty-five (25) pounds such as files or paper boxes.


"#INDHP"
 

Equal Opportunity Employer
Veteran Friendly Employer
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
DISCLOSURE TO EMPLOYEES PURSUANT TO THE CALIFORNIA  CONSUMER PRIVACY ACT (CCPA) – effective January 1, 2020

The Rawlings Group (“the Company”) is committed to protecting the privacy of its current, former and potential future employees. In compliance with the CCPA, the purpose of this Notice is to inform you that the Company collects, receives, maintains, and uses the Personal Information of current, former and potential future employees for the following business purposes:
  1. To comply with state and federal law and regulations requiring employers to maintain certain records;
  2. to process payroll;
  3. to maintain commercial insurance policies and coverages, including for workers’ compensation and other liability insurance;
  4. to manage workers’ compensation claims and requests for leave under the FMLA and/or the ADA;
  5. to administer and maintain group health insurance benefits, 401K and/or retirement plans;
  6. to manage employee performance of their job duties;
  7. to conduct workplace investigations (such as investigations of workplace accidents or injuries, harassment, or other misconduct);
  8. to evaluate job applicants and candidates for employment or promotions;
  9. to obtain and verify background checks on job applicants and employees;
  10. to evaluate, make, and communicate decisions regarding an employee’s employment, including decisions to hire, terminate, promote, demote, transfer, suspend or discipline;
  11. to communicate with employees regarding employment-related matters such as upcoming benefits enrollment deadlines, action items, availability of W2s, and other alerts and notifications;
  12. to grant employees access to secure Company facilities and maintain information on who accessed the facility;
  13. to implement, monitor, and manage electronic security measures on employee devices that are used to access Company networks and systems; and
  14. to engage in corporate transactions requiring review of employee records, such as for evaluating potential mergers and acquisitions of the Company;
  15. to comply with client contract requirements;
  16. to identify individuals visually on company systems;
  17. to process reimbursement/payment for professional licensing fees or tuition reimbursement
The Company collects, receives, and maintains the following categories of Personal Information of current, former, and potential future employees for the above business purposes as referenced by number:
 
CATEGORY EXAMPLES BUSINESS PURPOSE
Personal Identifiers Name, alias, postal or mailing address, email address, telephone number, social security number, driver’s license or state identification card number 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11
Physical Characteristics or Description height, weight, photograph(s) 5, 13, 16
Financial Information Bank account number, credit card number, debit card number, or other financial account information 1, 2
Protected Classifications Race, ethnicity, national origin, sex, gender, sexual orientation, gender identity, religion, age, disability, medical or mental condition, military status, familial status, language 1, 2, 7
Pre-Hire Information Job application, resume, background check results, drug test results, job interview notes, and candidate evaluation records 1, 2, 6, 7, 8, 9, 10, 14, 15
Professional or Employment-Related Information Personnel file, new hire or onboarding records, I-9 forms, tax forms, time and attendance records, non-medical leave of absence records, workplace injury and safety records, performance evaluations, disciplinary records, training records, licensing and certification records, compensation and health benefits records, and payroll information and records 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 14, 17
Medical and Health Information Doctor’s notes for absences or work restrictions, medical leave of absence records, requests for accommodation, interactive process records, and correspondence with employee and his/her medical or mental health provider(s) regarding any request for accommodation or medical leave of absence, as well as post-hire drug test results 1, 3, 4, 5, 6, 7, 10, 14
Education Information Transcripts or records of degrees and vocational certifications obtained 1, 6, 7, 8, 10, 14, 17
Visual, Audio or Video Recordings in the Workplace Surveillance cameras or pictures of employees taken in the workplace or at a Company function or event 4, 6, 7, 10, 12, 14
Facility Access Records Information identifying which employees accessed secure Company facilities and at what times using their keys, badges, fobs or other security access method 3, 4, 6, 7, 10, 12
Geolocation Data IP address and/or GPS location (latitude & longitude) recorded on Company-issued computers, electronic devices, and vehicles, as well as timekeeping applications on cell phones that employees use to clock in and out and that log the geographic location at which each time entry was made 4, 6, 7, 10, 13
Internet and Network Activity Internet or other electronic network activity information on Company-issued computers and electronic devices, including browsing history, search history, and usage history 1, 6, 7, 10, 13
Mobile Device Security Information Data identifying employee devices accessing Company networks and systems, including cell phone make, model, and serial number, cell phone number, and cell phone provider. 1,6,7,13

 

Job Summary
Employment Term and Type
Regular, Full Time
Hours per Week
40
Salary and Benefits
Base pay of $50,500 plus significant bonus opportunity
Required Education
Associate Degree
Required Experience
Open
Email this Job to Yourself or a Friend
Indicates required fields