MVA/Third Party Liability Resolution Specialist I

This is a fully remote position, open to applicants in United States.

📋 Description

• Assess potential MVA/TPL accounts to determine if they align with program and scope criteria.

• Examine registration, diagnosis, accident, insurance, clinical, billing, and account details to verify MVA/TPL status.

• Investigate accident specifics, responsible entities, insurance providers, claim numbers, attorney involvement, and reimbursement sources.

• Engage with patients, insurance providers, claims adjusters, attorneys, and other relevant parties.

• Ensure claims are submitted and carry out follow-up, resubmission, and supporting documentation tasks.

• Compile and submit claim documentation, which includes itemized statements, medical records, accident details, and other pertinent materials.

• Identify accounts needing corrected claims, demographic or insurance updates, coding reviews, or client-system adjustments and route requests accordingly.

• Prepare, submit, document, and monitor hospital liens.

• Track lien status, notices, documentation requirements, follow-up dates, and settlement activities.

• Maintain communication with liability carriers, attorneys, patients, and other relevant parties regarding claim status and reimbursements.

• Resolve routine payment, billing, documentation, and claim processing issues.

• Escalate disputed, delayed, underpaid, complex, or unusual accounts to a Level II Specialist or leadership.

• Review payments, adjustments, account balances, demographic changes, and account updates.

• Maintain comprehensive documentation of investigations, claim activities, communications, lien activities, payments, and final account outcomes.

• Utilize EHR, payer and carrier resources, client systems, and Revco account management systems to research assigned accounts.

• Prioritize daily tasks and identify recurring account issues or obstacles for leadership.

• Participate in training and ongoing development concerning MVA/TPL claims, hospital liens, and healthcare reimbursement.

• Perform additional duties and special projects as assigned.

⛳️ Requirements

• 1–3 years of experience in healthcare revenue cycle, medical billing, insurance follow-up, claims administration, MVA/TPL, workers' compensation, bodily injury claims, subrogation, medical liens, or a related field is preferred.

• Previous experience in hospital or provider-side revenue cycle is preferred.

• Knowledge of insurance claims, healthcare billing, payments, adjustments, and reimbursement processes is essential.

• Strong preference for candidates with MVA/TPL or liability claims experience, or relevant healthcare or insurance claims background.

• Ability to research account information, identify missing elements, and follow established procedures to resolution.

• Professional communication skills with patients, attorneys, claims adjusters, insurance providers, clients, and internal departments.

• Excellent written and verbal communication abilities.

• Strong organizational skills and the ability to follow up effectively.

• Proven attention to detail and accurate account documentation.

• Capability to manage multiple accounts and competing priorities.

• Experience with EPIC, Cerner, Meditech, CRXIS, or similar patient accounting/account management systems is preferred but not mandatory.

• Compliance with HIPAA, regulatory standards, client requirements, and company policies and procedures is required.

🏝️ Benefits

• Commitment to equal employment opportunities.

• Reasonable accommodations during the application and hiring processes for qualified individuals with disabilities and applicants with limitations due to pregnancy, childbirth, or related medical conditions.