MVA/Third Party Liability Resolution Specialist II

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

📋 Description

• Manage intricate MVA/TPL accounts autonomously from the initial investigation to the final resolution.

• Analyze registration, diagnosis, accident, insurance, clinical, billing, payment, legal, and account information to formulate recovery strategies.

• Investigate accident details, responsible parties, liability status, available coverage, claim numbers, policy limits, attorney representation, multiple claimants, and other reimbursement sources.

• Identify and pursue primary, secondary, and alternative recovery avenues.

• Evaluate, prepare, submit, document, monitor, and manage hospital liens and associated notices.

• Oversee settlements, lien deadlines, documentation requirements, coverage issues, and account milestones.

• Communicate with and negotiate terms with liability insurance carriers, claims adjusters, personal-injury attorneys, patients, and other involved parties.

• Assess settlement proposals and create counteroffers and recommendations for settlements.

• Negotiate resolutions within the designated authority and escalate issues needing approval.

• Research and resolve disputed, delayed, underpaid, denied, high-dollar, and complex accounts.

• Review payments, adjustments, account balances, settlement activities, and account dispositions for accurate final resolutions.

• Identify and escalate financial, compliance, lien, documentation, or recovery risks.

• Maintain thorough documentation of investigations, negotiations, settlement decisions, lien actions, and resolutions.

• Utilize EHR, payer and carrier resources, client systems, legal documentation, and Revco account-management systems.

• Ensure adherence to HIPAA, regulatory requirements, client demands, and company policies.

• Act as a resource for Level I Specialists.

• Assist leadership with training, workflow development, reference materials, templates, and best practices.

• Identify barriers to recovery and process inefficiencies, recommending reimbursement enhancements to leadership.

• Support escalated accounts, special projects, client initiatives, and additional management assignments.

⛳️ Requirements

• 3–5+ years of experience in MVA/TPL, bodily injury claims, subrogation, medical lien resolution, complex healthcare reimbursement, or a closely related liability-claims environment.

• Direct experience in hospital or provider-side revenue cycles is strongly preferred.

• Proven ability to independently investigate accident-related claims and identify available insurance coverage and other reimbursement sources.

• Experience in communicating and negotiating with liability insurance carriers, claims adjusters, attorneys, and other external parties.

• Familiarity with hospital liens and lien-related reimbursement processes.

• Strongly preferred experience in preparing, submitting, monitoring, and resolving hospital liens.

• California MVA/TPL and California hospital lien experience is highly preferred.

• Solid understanding of healthcare billing, account balances, claims, payments, adjustments, denials, and reimbursement processes.

• Ability to independently analyze complex accounts and devise suitable resolution strategies.

• Strong negotiation, critical-thinking, problem-solving, and decision-making capabilities.

• Ability to evaluate settlement proposals and formulate well-supported recommendations.

• Excellent written and verbal communication skills.

• Capability to manage complex, high-priority accounts with varying deadlines and resolution requirements.

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

• Healthcare revenue-cycle, claims, insurance, or liability-related certifications are advantageous but not required.

🏝️ Benefits

• Commitment to equal employment opportunity.

• Reasonable accommodations for qualified individuals with disabilities and applicants with pregnancy, childbirth, or related medical condition limitations.