Recovery and Subrogation Specialist
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Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota’s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We’re an organization that’s going places. Be part of a team that cares about you, be part of UCare.
As the Recovery and Subrogation Specialist, you will audit, analyze and investigate paid claims and supporting documentation for potential recovery of claims processing system. Initiates changes to policy and procedures to reduce system and manual processing errors. Work with Finance Department to process provider claims refunds and resolve financial deficits. Refer claims for investigation to the Compliance Auditor when fraud is expected. Provide additional claims analysis to support investigations as needed. Oral and written communication with providers and other internal departments. Coordinate all aspects of third party liability on UCare’s behalf.
A two year Associates degree is preferred. Coursework in medical terminology, CPT-4 and ICD-9 coding is required. Relevant work experience will be considered in lieu of a two-year degree.
A minimum of three to five years claims experience in Medicare, Medicaid, HMO and/or indemnity claims processing, CPT and ICD-9 coding and medical terminology is required. Experience with CMS guidelines and DHS claims processing guidelines, provider contracts and benefit set-up is necessary. Detail oriented with strong analytical and data entry skills and demonstrated experience with Access and Excel is also required. Candidates must have experience working with Medicare Secondary Payer rules and how it applies to Third Party Liability. Knowledge of Medicaid, General Assistance, Medical Assistance, Minnesota Care and Medicare is helpful. Previous Amisys Claims System and MACESS Exp experience a plus.
***This position is part time (.5) FTE working 20 hours per week.***
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve. EOE/AA
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You’ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis—just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.