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Medical Claims Recovery Specialist

Gainwell
hybrid
Tallahassee, FL, US

About this role

Medical Claims Recovery Specialist

Summary

We are seeking a Medical Claims Recovery Specialist to manage all casualty and estate functions involving state Medicaid beneficiaries or deceased Medicaid beneficiaries. This role is responsible for the intake, maintenance, claims review, case management, settlement, and all related activities within the assigned caseload.

Your role in our mission

  • Ensure all processes meet HIPAA and government security requirements regarding the sharing and storage of Personal Health Information (PHI).
  • Utilize strong analytical and case management skills to oversee 700–1,000 subrogation cases simultaneously.
  • Communicate professionally—primarily via inbound and outbound calls—with attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and clients.

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