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Healthcare Claims Case Worker job in Raleigh at Confidential

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Healthcare Claims Case Worker at Confidential

Healthcare Claims Case Worker

Confidential Contractor
$17.00/ hour
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One of the world's leading healthcare companies is looking for a Subrogation Case Worker to join their team! The Subrogation Case Worker I is responsible for processing all casualty or estate functions involving several state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes intake, maintenance, claims review and selection, management, settlement and related functions to the case.

Main Duties & Responsibilities:

  • Effectively work, maintain and manage a variety of cases with current and accurate notes.
  • May have some training responsibilities for other case workers limited to projects and specific tasks.
  • Maintain a daily system of providing timely and accurate information required to move cases through the verification and case management pipeline.
  • Verify documents and coordinate health care coverage for patients, including eligibility of benefits.
  • Professional interaction with attorneys, insurance adjusters, medical providers, court staff, recipients and family members.
  • Negotiate lien settlements per contract guidelines.
  • Prepare required correspondence, liens, claims and other related documents.
  • Perform basic and advanced levels of document review, legal research, and case management.
  • Compile, analyze and make conclusions about information from multiple sources.
  • Give special attention to the timely processing of events, various legal deadlines, and critical accounting/finance issues.
  • Process Intake referral leads from attorneys, insurance adjusters, personal representatives, stakeholders and medical providers.
  • Review and research leads regarding potential accident or trauma situations.
  • Handle phone inquiries for both demand package issues and from beneficiaries promptly and with courtesy.
  • Meet department objective standards for Customer Service, Probate Research, Asset research, Document Review and Intake.
  • Complete periodic reports for management when necessary.

Required Skills:

  • Ability to interface with all levels of people both internally and externally in a professional manner.
  • Ability to communicate and comprehend well both verbally and in writing, fluently in English.
  • Ability to be careful and thorough about detail including with cite-checking and proofreading skills.
  • Ability to work proficiently with Microsoft Office, Word, and Excel.
  • Ability to work independently to meet objectives.
  • Ability to maintain a high level of confidentiality and ethics.
  • Ability to function effectively under pressure and manage deadline oriented project demands and multiple initiatives.
  • Ability to sit for long periods of time.
  • Ability to multi-task and prioritize effectively.
  • Ability to analyze information and use logic to address work-related issues and problems.
  • Ability to perform oral presentations with good quality.
  • Ability to perform well in team environment, to achieve business goals.
  • Average manual dexterity work in use of a PC, phone, sorting, filing and other office machines.

Required Education/Experience:

  • High School Diploma or GED
  • Associates degree preferred
  • 3 years experience working in a professional office environment. 
  • Basic knowledge of Microsoft Word and Excel.
  • Basic knowledge of Microsoft Access preferred.
  • Medicaid and/or Medicare knowledge preferred.
  • Bilingual (Spanish & English) a plus.

Additional Details:

  • Location: Raleigh NC
  • Pay: $17/hr
  • Duration: 3 months

Recommended Skills

Call Centers
Customer Service
Detail Orientated
Healthcare Claims
Microsoft Office
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