Medical Claims Recovery Specialist (Subrogation) - Tallahassee, FL - Hybrid

Medical Claims Recovery Specialist (Subrogation) - Tallahassee, FL - Hybrid

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary: We are seeking a Medical Claims Recovery Specialist to manage all casualty and estate functions involving state Medicaid beneficiaries or deceased Medicaid beneficiaries. This role is responsible for the intake, maintenance, claims review, case management, settlement, and all related activities within the assigned caseload.

Your role in our mission: Ensure all processes meet HIPAA and government security requirements regarding the sharing and storage of Personal Health Information (PHI). Utilize strong analytical and case management skills to oversee 7001,000 subrogation cases simultaneously. Communicate professionallyprimarily via inbound and outbound callswith attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and clients. Prepare and manage required correspondence, liens, claims, and related documentation throughout the recovery process. Meet departmental goals for customer service, settlements, and case handling standards. Perform both basic and advanced document and legal reviews to determine case status, ensure accuracy, and support workflow progression. Verify beneficiary eligibility and maintain accurate documentation. Confirm and validate third-party liability, probate, and asset research findings. Compile and analyze information from multiple sources to determine case status and recovery potential. Process and resolve claim or lien disputes; collaborate with attorneys and relevant stakeholders as needed. Conduct periodic follow-ups on case status, payments, and settlement updates. Negotiate and finalize claim or lien settlement amounts according to established contract guidelines. Execute and file notarized documents with applicable county offices. Prioritize case events, payment issues, and revenue-impacting deadlines to ensure timely resolution. Maintain accuracy, timeliness, and productivity standards for file management and phone metrics.

What we're looking for: 2+ years of relevant professional experience in subrogation, claims, or case management. Proficiency in Microsoft Word and Excel; basic knowledge of Microsoft Access is preferred. Experience in a legal or insurance office setting (paralegal, legal assistant, casualty, or health insurance experience preferred). Familiarity with Medicaid and/or Medicare programs is preferred.

What you should expect in this role: Hybrid work arrangement based in the Tallahassee, FL office onsite 2 days per week. Schedule: MondayFriday, 8:00 AM 5:00 PM. Video cameras are required during all interviews and throughout the first week of orientation. To work effectively as a teleworker or hybrid employee, you must have broadband internet with a minimum speed of 24 Mbps download and 8 Mbps upload (higher speeds recommended for optimal performance). This posting is intended for pipelining. We will accept applications on an ongoing basis.

The pay range for this position is $43,500.00 - $48,000.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth.