Subrogation Specialist jobs in Billings, MT

Subrogation Specialist is responsible for subrogation activities including the identification and research of subrogation claims. Assists in the recovery of overpayments for duplicate coverage, workers' compensation, and no-fault claims. Being a Subrogation Specialist identifies legal liability and pursues, negotiates, and settles subrogation collection. Researches paid claims, answers inquiries, and coordinates with other departments, insurance adjustors, attorneys, and members. Additionally, Subrogation Specialist interacts with policyholders, claimants, witnesses, and underwriters to recommend and document the necessary information to close a file. Collects information needed to determine when an on-site investigation is necessary. Requires a high school diploma or equivalent. Typically reports to a supervisor or manager. The Subrogation Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Subrogation Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Authorizations Specialist
  • billingsclinic
  • Billings, MT FULL_TIME
  • Responsible for performing the medication authorization functions with insurance carriers. Coordinate with/educate physicians, nursing staff and other health care providers on the authorization process and requirements. Works as a patient advocate and functions as a liaison between the patient, staff and payer to answer avoid care delays. Tracks, documents, and monitors authorizations. Implements check and balance systems to ensure timely compliance. Processes complete prescription claims including proper adjudication/reconciliation, insurance verification, prior authorization, and compassionate care/medication assistance programs associated with patient accounts and insurance claims billing.

    Essential Job Functions

    •Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
    •Coordinates medication authorization process ensuring authorization has been obtained.
    •Identifies and initiates precertification/authorization requirements for individual payers and communicates with payer sources in a timely manner to obtain necessary pre-certification/authorization.
    •Processes complete prescription claims including proper adjudication/reconciliation, insurance verification, prior authorization, and compassionate care/medication assistance programs associated with patient accounts and insurance claims billing.
    •Enters medication charges and credits for the adjudication/reconciliation of patient accounts and insurance claims billing.
    •Participates in quality improvement activities utilizing performance improvement principles to assess and improve quality.
    •Documents and maintains patient specific precertification/authorization data within the required information systems. Documents and tracks authorizations using established process.
    •Reports denials and/or delays in the precertification/authorization process to physicians/other health care providers and/or the patient.
    •Develops and maintains collaborative working relationships with payers and health care team.
    •Reports non-compliance issues to department specific leadership team.
    •Works with Medical Staff Office validating provider enrollment and NPI numbers.
    •Tracks and verifies that medication precertification/authorization has been received either verbally or written.
    •Communicates status to health care team and patient as needed. Reviews schedules and work lists multiple times throughout the day.
    •Reports medication denials and/or delays in the authorization process to the health care team and the patient. Provides information to the patient on the appropriate appeal process for denials as needed.

    Additional Duties: Concurrent – Authorization
    •Understands insurance/payer policy language, benefits and authorization requirements upon admission, for concurrent review, and for discharge.
    •Coordinates Peer to Peer reviews. Submits letters of medical necessity and follows up on payer denial outcomes.
    •Participates in continuing education, department planning, work teams and process improvement activities.
    •Conducts follow-up calls, as necessary, to third party payers to complete authorization process validating that all days are authorized.
    •Facilitates retro-authorization process with payers. Communicates outcome with patient, physician, Patient Financial Services and other key departments
    •Responsible for coordinating resolution of varied problem situations and performing necessary investigation and research as it relates to the authorization process to resolve pre-certification/authorization problems.
    •Works closely with Payer Relations coordinating needed pre-certification/ authorizations for in-network and out of network services.
    •Maintains reference manuals that outline the individual payer requirements as it relates to precertification and authorization needs while also being responsible for the integrity and accuracy of the payer data.
    •Responsible for the orientation and education of physician, nursing staff, who rely on the pre-certification process.
    •Works with Coding Resources validating correct and billable CPT code, Writes process with critical elements for new procedures and maintains pre-certification instruction manual.
    •Reviews, updates and standardizes forms and processes as needed.
    Initiates workflow for new procedures/service lines.

  • 18 Days Ago

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Maintenance Specialist
  • MAC LTT Manufacturing, Inc
  • Billings, MT FULL_TIME
  • We are seeking a highly skilled individual who can troubleshoot and perform maintenance on manufacturing equipment and the facility. ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. (Othe...
  • 21 Days Ago

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Benefits Specialist
  • Billings Clinic Health System
  • Billings, MT OTHER
  • Under general supervision, the incumbent in this position provides administrative, clerical and technical support within the areas of benefits and compensation.Essential Job Functions •Supports and mo...
  • 21 Days Ago

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Merchandiser Specialist
  • Acosta Group
  • Cody, WY FULL_TIME
  • **Start your career with Premium.** \#WeArePremium **Merchandiser Specialist** **General Information** **Company:** PRE-US **Location:** CODY, Wyoming, 82414 **Ref #:** 25308 **Function:** Merchandisi...
  • 21 Days Ago

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Authorizations Specialist
  • Billings Clinic
  • Billings, MT FULL_TIME
  • You’ll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the...
  • 21 Days Ago

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Insurance specialist
  • BMO Financial Group
  • Billings, MT FULL_TIME
  • BMO is hiring an Insurance Claims Specialist to join the Transportation Finance Operations team. BMO Transportation Finance serves the entire supply chain of the transportation industry, including ori...
  • 23 Days Ago

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0 Subrogation Specialist jobs found in Billings, MT area

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L&D RN
  • TotalMed
  • Billings, MT
  • We are seeking a Registered Nurse-Labor and Delivery for a travel assignment in Billings Montana.
  • 3/28/2024 12:00:00 AM

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Cashier
  • Buffalo Wild Wings
  • Billings, MT
  • Buffalo Wild Wings has an atmosphere that creates stories worth telling - for our guests and for our team members. Yes, ...
  • 3/28/2024 12:00:00 AM

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Delivery Representative
  • UGI Corporation
  • Billings, MT
  • The hourly rate starts at $26.75, depending on circumstances including an applicant's skills and qualifications, certain...
  • 3/28/2024 12:00:00 AM

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Hydraulics Project Engineer
  • Impact Recruitment
  • Billings, MT
  • Impact Recruitment is currently looking for a Hydraulics Project Engineer eager for an opportunity to join an award-winn...
  • 3/28/2024 12:00:00 AM

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Construction Safety Loss Control Consultant (upper Mid-Western states)
  • Gallagher Bassett
  • Billings, MT
  • Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities...
  • 3/28/2024 12:00:00 AM

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Senior Project Engineer- Land Development
  • Impact Recruitment
  • Billings, MT
  • Impact Recruitment is currently looking for a Senior Project Engineer eager for an opportunity to manage a diverse portf...
  • 3/28/2024 12:00:00 AM

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Medical Oncologist
  • Intermountain Healthcare
  • Billings, MT
  • Job Description: It's not all about the WORK! It's also about the PLAY! Live, work, play in Montana! Montana is one of t...
  • 3/28/2024 12:00:00 AM

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Certified Nursing Assistant Orthopedics
  • Intermountain Healthcare
  • Billings, MT
  • Job Description: The Certified Nurse Assistant functions as a clinical support partner to assist the patient care team b...
  • 3/28/2024 12:00:00 AM

Billings is the largest city in the U.S. state of Montana, with a population estimated at 109,642 as of 2017. Located in the south-central portion of the state, it is the seat of Yellowstone County and the principal city of the Billings Metropolitan Area, which has a total a population of 170,498. It has a trade area of over 500,000. Billings was nicknamed the "Magic City" because of its rapid growth from its founding as a railroad town in March 1882. The city is named for Frederick H. Billings, a former president of the Northern Pacific Railroad. With one of the largest trade areas in the Uni...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Subrogation Specialist jobs
$41,032 to $50,842
Billings, Montana area prices
were up 3.1% from a year ago

Subrogation Specialist in Frankfort, KY
You will then seek subrogation against contractor and his insurer to get them to pay for the damages paid out.
December 27, 2019
Subrogation Specialist in Port Arthur, TX
Enroll in the certified subrogation recovery professional program offered by the National Association of Subrogation Professionals.
December 02, 2019
Afni is hiring Subrogation Specialists that are primarily responsible for assisting in the recovery of subrogation claims typically from insurance carriers and self-insured entities.
February 07, 2020
Subrogation Specialist in San Jose, CA
Train in areas of handling subrogation payments, arbitration, and the disposition of salvage.
January 24, 2020