Investigations Analyst

This is a fully remote position, open to applicants in Florida, +5 more states.

📋 Description

• Conduct investigations to assess subrogation potential.

• Analyze and investigate claims platforms to verify coverage eligibility and plan details (20%).

• Input missing case information into the case management system (55%).

• Examine documentation to ensure uniformity in case setup (15%).

• Reach out to external clients via phone and email to gather additional case information (8%).

• Record daily outcomes in the production tracker (2%).

• Utilize accident information, as well as state and federal compliance policies, reimbursement policies, and contract compliance to carry out investigations.

• Prepare subrogation files for the Recovery Specialist team.

⛳️ Requirements

• High School Diploma or equivalent.

• Minimum of 2 years of experience in claims investigation or a related area.

• Strong communication and teamwork abilities.

• Proficient in claims systems and subrogation tools.

• Knowledge of healthcare coding (CPT, ICD-10) is 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 continue throughout employment.

🏝️ Benefits

• Comprehensive medical, dental, and vision coverage.

• Wellness program offering resources for healthy living.

• Health Savings Account (HSA) and Flexible Spending Account (FSA) for tax-free savings.

• Tuition reimbursement opportunities.

• Generous PTO to allow for recharging.

• Paid holidays and sick time.

• Leave options to accommodate life’s significant moments.

• Life and Disability insurance provided through Unum.

• Voluntary coverage options for added peace of mind (Critical Illness, Accident, Hospital Indemnity, Legal, and Identity Protection).

• Employee Assistance Program (EAP) offering free, confidential counseling and support.

• Remote work options available for many positions.

• Flexible schedules in select roles.