Sanford Health

Nonprofit health system operating hospitals

Recovery Specialist

Claims AdjudicationConfirmed live in the last 24 hours

Full-time$18 - $29Remote

About the Job

Requirements

An associate degree in business, legal, or a healthcare-related field is required; three years of applicable work experience may be accepted in lieu of education.
At least one year of work experience with coding, insurance processes, liability, subrogation, coordination of benefits, or workers’ compensation claim adjudication is required.

Responsibilities

Identify and research third-party claims and recover overpayments involving workers’ compensation, no-fault claims, hospital liens, and other accident or liability claims.
Identify legal liability and pursue, negotiate, and settle subrogation, lien, and reimbursement recoveries.
Apply applicable laws, regulations, and policy language to achieve recoveries in accordance with mandates.
Negotiate lien settlements with attorneys and other responsible representatives to obtain maximum recovery.
Assist with responses to summonses, complaints, and interrogatories from attorneys when a suit has been commenced.
Communicate legal rights to involved parties and place them on notice of liens.
Review medical charges to identify relatedness.
Maintain detailed recovery records to ensure case facts are accurate.
Maintain technical skill and knowledge of recovery processes and serve as a resource to the department.
Review and meet ongoing competency requirements to maintain the skills, knowledge, and abilities to perform role-specific functions within scope.

Desired Qualifications

A Certified Subrogation Recovery Professional (CSRP) designation from the National Association of Subrogation Professionals (NASP) is preferred.

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland.

Work Shift:

8 Hours - Day Shifts (United States of America)



Scheduled Weekly Hours:

Compensation:

Salary Range: $18.00 - $29.00





Union Position:

Department Details

Summary

The Recovery Specialist is responsible for the identification and research of third party claims. Works for the recovery of overpayments involving workers compensation, no-fault, hospital liens, and any other type of accident or liability claims. Identifies legal liability, and pursues, negotiates, and settles subrogation, liens, and reimbursement recoveries.

Job Description

Applies applicable laws, regulations, and policy language to achieve recoveries in accordance to mandates. Negotiates lien settlements with attorneys and other responsible representatives to obtain maximum recovery. Assists in response to Summons and Complaint and interrogatories from attorneys where suit has been commenced. Communicates legal rights to all involved parties placing them on notice of lien. Reviews medical charges to identify relatedness. Maintains detailed recovery records to ensure case facts are accurate. Maintains a high level of technical skill and knowledge of recovery processes to act as a resource to the department. Reviews and meets ongoing competency requirements of the role to maintain the skills, knowledge and abilities to perform, within scope, role specific functions.

Qualifications

Associates degree in business, legal, or healthcare related field required. In lieu of education leadership may accept three years’ applicable work experience.

Minimum of one year work experience with coding, insurance processes, liability, subrogation, coordination of benefits or workers' compensation claim adjudication.

CSRP (Certified Subrogation Recovery Professional) designation from NASP (National Association of Subrogation Professionals) preferred.

Sanford is an EEO/AA Employer M/F/Disability/Vet.

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-949-5678 or send an email to [email protected].

About the Company

Sanford Health

Nonprofit health system operating hospitals

Sanford Health is a large nonprofit health system that delivers hospital care, elder and post-acute services, and related health care through a network of hospitals, clinics, and senior care facilities across the Midwest. It operates by integrating multiple care settings into one system, supported by research and global health initiatives. Its model combines acute hospital care, long-term care, and post-acute services under a single organization, with a strong emphasis on philanthropy and mergers to expand reach and capabilities. The company differentiates itself through its breadth of services across the care continuum, extensive rural and regional presence, and a history of strategic mergers that create a full-spectrum care model rather than focusing on a single niche. Sanford Health’s goal is to provide comprehensive, accessible health care to communities, advance pediatric care and medical research, and extend health services through global clinics and partnerships.

Company size: 10,001+
Company stage: Grant
Total funding: $4.5M
Headquarters: Fargo, ND
Founded: 1894

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