Providence Health & Services Subrogation Analyst in Beaverton, Oregon
Providence is calling a Subrogation Analyst to Providence Health & Services in Beaverton, OR.
In this position you will have the following responsibilities:
Negotiate third party settlements with attorneys, adverse carriers or members to ensure maximum recovery.
Communicate with outside members and attorneys while TPL cases are still open and settlement has not been reached. Ensuring all necessary documents have been received.
Provides medical liens to attorneys to assist in negotiating settlement and facilitating reimbursement to PHP.
Monitor subpoenas and records requests for timeliness.
Obtain and maintain information for identified cases including: at fault parties, adverse carrier contact information, policy limit verification, attorney contact information, copies of all related correspondence including settlement documents.
Follow up on open cases to determine if settlement has occurred.
Utilize assistance from RCGA or internal legal staff when appropriate.
Utilize essential decision making skills to determine if a claim can be released or if further investigation needs to be made for potential third party liability.
Required qualifications for this position include:
2 years experience in Subrogation
4 years experience in a healthcare environment
Current working knowledge of IDC9/ICD-10 and CPT coding
Knowledge of state regulations related to third party liability (auto carrier, work comp, premise, mal-practice and product liability)
Familiarity with NAIC guidelines, State and Federal regulations
Proven track record demonstrating excellent communication skills/techniques when dealing with third party carriers, attorneys, members and providers in handling sensitive situations in a positive and professional manner, adhering to HIPAA guidelines
Preferred qualifications for this position include:
Bachelor’s Degree preferred; Juris Doctorate degree is a plus
Claims adjudication experience
Experience with Facets claims software
Strong analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions and the ability to work independently with self-initiative
Attention to detail is critical, mistakes impact our internal and external customers (data integrity)
Excellent negotiation skills to maximize settlement
Extensive knowledge of products, plans, and benefits offered by PHP and PHA and the impact on departments and workflow within PHP and PSJH
Working knowledge of provider contracts and understanding of business and provider environments in each of service areas
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Finance
Req ID: 225453