Subrogation Specialist, Sr. jobs in Nevada

Subrogation Specialist, Sr. is responsible for subrogation activities including the identification and research of subrogation claims. Assists in the recovery of overpayments. Being a Subrogation Specialist, Sr. coordinates with other departments, insurance representatives and members. Processes subrogation, workers' compensation, and other claims where third-party liability exists. Additionally, Subrogation Specialist, Sr. develops cases resulting from beneficiary or provider-initiated inquiries, internal referrals, personal research, or computer-generated reports. Requires a high school diploma. Typically reports to a supervisor. The Subrogation Specialist, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Subrogation Specialist, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)

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Sr Insurance and Claims Specialist
  • Renown Health
  • Reno, NV FULL_TIME
  • Position Purpose

    The Senior Insurance and Claims Specialist is responsible for compliant billing, account follow up and system operations to ensure timely and accurate claim submission and prevention of denials per regulatory and payor requirements, as well as improved payment turnaround.

     

     

     

    Nature and Scope

    The Senior Insurance and Claim Specialist is responsible for:

     

    • Optimization of system that will ensure accurate claim submission and follow-up resulting in timely reimbursement per payor and regulatory guidelines.

    • Complete detailed appeal of denial or payment variance to payor, incorporating contract terms, clinical or regulatory justification for reconsideration or additional reimbursement.

    • Recommend system changes for clean claim submission to aid in the prevention of denials.

    • Work with the Renown Contracting Department or payor representatives to resolve billing issues due to payor or regulatory changes affecting the billing of healthcare claims.

    • Assisting with testing and troubleshooting of system for payor or regulatory changes.

    • Maintaining expertise for all payor, HIPAA and other regulatory changes affecting the billing of healthcare claims.

    • Working hand in hand with Operations Analysts and Information Technology to maintain and improve business system changes based on payor or regulatory changes.

    • Acts as a resource for staff on all areas relating to edit and denial/rejection resolution.

    • Identify trends in payor non-compliance and inform management if not able to resolve with payor.

    • Demonstrates a thorough knowledge of all department functions, processes, and procedures.

     

    This position does not provide patient care.

     

     

    Disclaimer

    The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

     

     

     

    Minimum Qualifications
    Requirements - Required and/or Preferred

    Name

    Description

    Education:

    Must have working-level knowledge of the English language, including reading, writing and speaking English. Associates Degree Preferred.

    Experience:

    Two years healthcare billing office experience with extensive knowledge of healthcare billing, government and third party payor requirements.

    License(s):

    None

    Certification(s):

    Coding Certification Preferred for Professional Billing.

    Computer / Typing:

    Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.

     

     

  • 11 Days Ago

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Aerie - Sr Brand Ambassador (Sr Sales Associate) - US
  • Sr Brand Ambassador (Sr Sales Associate) - US - American Eagle Outfitters Careers
  • United States, NV FULL_TIME
  • BE PART OF SOMETHING REAL YOUR ROLE As a part-time Sr Brand Ambassador, you bring our brand to life every day! Your goal is to provide everyone who comes in the store with an amazing shopping experien...
  • 18 Days Ago

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AE - Sr Brand Ambassador (Sr Sales Associate) - US
  • Sr Brand Ambassador (Sr Sales Associate) - US - American Eagle Outfitters Careers
  • United States, NV FULL_TIME
  • BE PART OF SOMETHING REAL YOUR ROLE As a part-time Sr Brand Ambassador, you bring our brand to life every day! Your goal is to provide everyone who comes in the store with an amazing shopping experien...
  • 18 Days Ago

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2019-2020 General Resource Room Cooperative Teacher, 9-12
  • Juvenile Det. JR/SR
  • Las Vegas, NV FULL_TIME
  • 2019-2020 General Resource Room Cooperative Teacher, 9-12
  • 23 Days Ago

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Project Manager (Construction)
  • SR Construction, Inc.
  • Reno, NV FULL_TIME
  • Are you an analytical thinker who loves to solve tangible problems? Are you great at seeing big picture objectives and instinctually knowing the fastest route to get there? Do people who talk too much...
  • 24 Days Ago

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Construction Estimator
  • SR Construction, Inc.
  • Las Vegas, NV FULL_TIME
  • SR Construction is a full-service design/build general contractor founded in 1991 with the primary goal of providing our clients with the highest degree of quality and the greatest level of service on...
  • 1 Day Ago

Nevada is almost entirely within the Basin and Range Province, and is broken up by many north-south mountain ranges. Most of these ranges have endorheic valleys between them, which belies the image portrayed by the term Great Basin. Much of the northern part of the state is within the Great Basin, a mild desert that experiences hot temperatures in the summer and cold temperatures in the winter. Occasionally, moisture from the Arizona Monsoon will cause summer thunderstorms; Pacific storms may blanket the area with snow. The state's highest recorded temperature was 125 °F (52 °C) in Laughlin (e...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Subrogation Specialist, Sr. jobs
$53,826 to $68,053