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 $47,000 plus significant bonus potential! An experienced Recovery Analyst averages over $80,000 per year!
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
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.
* 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
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.
Equal Opportunity Employer