Health Management Systems, Inc. Subrogation Call Center Representative in Irving, Texas

The Subrogation Call Center Representative position is responsible for answering all casualty or estate call involving several state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes, but is not limited to calls from attorneys, paralegal, insurance agents, Medicaid members and their families.

Main Duties and Responsibilities:

  • Effectively review and update a variety of cases with current and accurate case notes

  • Provide case status updates while speaking with multiple parties such as attorneys and members regarding their case history, current status and next steps.

  • Conduct all case document review and updates while speaking with the member or attorney as needed

  • Maintain a daily system of providing timely and accurate information required to move cases through the case management workflow.

  • Interact professionally (incoming and outgoing calls and correspondence) with attorneys, insurance adjusters, medical providers, court staff, recipients and family members and client.

  • Perform basic and advanced levels of document review to identify current case status and case management and ensure case progress through workflow

  • Meet department objective standards for Customer Service

  • Verify and adhere to HIPPA standards while speaking with members and attorneys on the phone

  • Ensure all processes meet HIPAA and Government security requirements with regards to sharing/storage/PHI (Personal Health Information).

  • Open new cases and update all current case information

  • May have additional responsibilities as needed to assist with case intake and verification process tasks

  • May have some training responsibilities limited to projects and specific tasks

Additional Essential Functions:

  • Ability to interface with all levels of people both internally and externally in a professional manner.

  • Ability to communicate and comprehend well both verbally and in writing, fluently in English.

  • Ability to be careful and thorough about detail including with cite-checking and proofreading skills.

  • Ability to multi-task and prioritize effectively.

  • Ability to work proficiently with Microsoft Office, Word, and Excel required

  • Ability to work independently to meet objectives.

  • Ability to analyze information and use logic to address work-related issues and problems.

  • Ability to perform oral presentations with good quality.

  • Ability to perform well in team environment, to achieve business goals.

  • Ability to maintain a high level of confidentiality and ethics.

  • Ability to function effectively under pressure and manage deadline oriented project demands and multiple initiatives.

  • Ability to sit for long periods of time.

  • Ability to perform the following: lifting, bending, pushing, pulling, stopping, kneeling, reaching, and carrying of light to heavy items (40 to 50lbs).

  • Average manual dexterity work in use of a PC, phone, sorting, filing and other office machines.

Minimum Education:

  • High School or GED required

  • Associates degree preferred

Minimum Related Work Experience:

  • 1 years’ experience working in a professional office environment.

  • Experience working in a call center preferred

  • Experience in the insurance industry (casualty or health insurance) a plus

  • Knowledge of Microsoft Word and Excelrequired.

  • Medicaid and/or Medicare knowledge preferred.

  • Bilingual (Spanish & English) a plus.

Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Title: Subrogation Call Center Representative

Location: Texas-Irving

Requisition ID: 1700110G