Manager, Recoveries

About the role

Responsible for managing the Coordination of Benefits and Third Party Liability organizations. Oversee the process of recovering funds from other health insurance plans and liable third parties for claim-related expenses and ensuring compliance with relevant laws and regulations. Lead the identification of responsible parties, evaluation of claims, and manage the end-to-end recovery process, often working with insurance companies, attorneys, and other stakeholders. This role also involves supervising staff, developing and implementing strategies to optimize cost recovery, and maintaining accurate records while ensuring that all recovery efforts are conducted in compliance with the organization's policies and regulatory requirements.

Responsibilities

• Oversee the Coordination of Benefits and Third Party Liability processes for recovering funds related to COB and TPL claims.
• Develop and implement strategies to maximize recovery rates and minimize revenue loss.
• Manage, mentor, and train the Recoveries Team to ensure efficient and effective handling of accounts.
• Conduct performance evaluations, provide feedback, and support professional development for team members.
• Review and analyze denied claims and billing issues to determine the root cause and appropriate course of action.

Requirements

• Bachelor's Degree required; experience can be considered in lieu of a degree.
• At least 5-7 years of experience in COB, TPL, and claims adjudication experience required.
• At least 2-3 years of experience in a supervisory or leadership role required.
• At least 2-3 years of experience within a health plan setting preferred.

Qualifications

• Strong knowledge of health insurance claims, coordination of benefits, and third-party liability.
• Excellent leadership, organizational, and team management skills.
• Proficiency in using health plan software and tools.
• Strong analytical and problem-solving skills with attention to detail.
• Effective communication and interpersonal skills.

Skills

• Strong knowledge of health insurance claims, coordination of benefits, and third-party liability.
• Excellent leadership, organizational, and team management skills.
• Proficiency in using health plan software and tools.
• Strong analytical and problem-solving skills with attention to detail.
• Effective communication and interpersonal skills.

Benefits

• Competitive salaries and a benefits package with flexible work options, career growth opportunities, and much more.

Pay

$99,465.60 - $144,643.20/Annual

Schedule

Day (United States of America)