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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in claims investigation and subrogation processes, with a strong focus on compliance with state and federal regulations. Proficient in utilizing claims systems and healthcare coding to ensure accurate case management and documentation.
Highest-signal resume keywords
Claims Investigation ExperienceProficiency in Claims SystemsKnowledge of Healthcare CodingStrong Communication SkillsCollaboration Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims InvestigationSubrogation ProcessesHealthcare CodingCPT CodingICD-10 Coding
Soft Skills
Strong CommunicationCollaboration
Tools & Technologies
Claims SystemsCase Management SystemProduction Tracker
Industry Keywords
SubrogationCompliance PoliciesReimbursement PoliciesCase SetupCoverage Eligibility
About the role
Key responsibilities & impact- Complete investigations to determine subrogation potential
- Review and investigate claims platforms to determine coverage eligibility and plan information (20%)
- Enter missing case details into the case management system (55%)
- Review documentation to ensure consistent case setup (15%)
- Contact external customers by phone and email to solicit additional case information (8%)
- Enter daily results into the production tracker (2%)
- Use accident details, state and federal compliance policies, reimbursement policies, and contract compliance to complete investigations
- Prepare subrogation files for the Recovery Specialist team
Requirements
What you’ll need- High School Diploma or equivalent
- 2+ years experience in claims investigation or related field
- Strong communication and collaboration skills
- Proficiency in claims systems and subrogation tools
- Knowledge of healthcare coding (CPT, ICD-10) preferred
- Must reside in Georgia, Florida, Pennsylvania, Kentucky, Texas, Wisconsin, or Michigan
- Must be legally authorized to work from one of these states at the time of hire and throughout employment
Benefits
Comp & perks- Comprehensive medical, dental, and vision coverage
- Wellness program with resources for healthy living
- Health Savings Account (HSA) and Flexible Spending Account (FSA) for tax-free savings
- Tuition reimbursement opportunities
- Generous PTO so you can recharge
- Paid holidays and sick time
- Leave options to support life’s biggest moments
- Life and Disability insurance through Unum
- Voluntary coverage options for added peace of mind (Critical Illness, Accident, Hospital Indemnity, Legal, and Identity Protection)
- Employee Assistance Program (EAP) for free, confidential counseling and support
- Remote work options available for many roles
- Flexible schedules in select positions