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Posted: Sunday, October 22, 2017 12:09 AM

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About the Job

Job Description

Job #: 783723

If interested, please email an updated word document of your resume and a good time to talk to Regan Potter at rpotter@apexsystemsinc.com for consideration!

Job Title: Healthcare Claims Insurance Liability Recovery Associate

Location: Quincy, MA

Rate: $16-$18/hour

Contract Length: 6 months

Job Description:

  • Looking for Healthcare Claims Insurance Liability Recovery Associate.
  • This position is responsible for investigating potential subrogation identifications.
  • The Third Party Liability Associate will review associated claims and correspondence to determine correct payment, adjust claims appropriately and update systems for future claim payment. Manages insurance verifications for all programs. Verifies Medicaid, Medicare, and all other insurance company eligibility, and all other insurance coverage. This position will contact members, attorneys, insurers and providers to determine subrogation recovery potential and obtain the information necessary to open a case when appropriate. The Claims Insurance Liability Recovery Associate must understand all the claims processing requirements and ensure recoveries related to coordination of benefits and third party liability recovery efforts and are pursued and completed within the regulatory timelines.

Role Responsibilities:

  • Conduct research and investigate claims to determine subrogation recovery potential. Review, process or adjust claims for one or more of the specialized functions handled by the unit and ensure timely and accurate payment or denial. Coordinate benefits with other available coverages, review correspondence to determine accurate payment and update claim systems regarding future payment. Open new cases in the case management system. Create and update medical lien requests. Place all parties of interest on notice and provide lien information.


What are the three to five primary responsibilities of the position?:

  • High school diploma or equivalent required.
  • Minimum 1-2 years of COB / Medicare Claims
  • Experience and 2-3 years medical claims examining experience, or equivalent of the two
  • Must be familiar with coordination of benefits processes and related regulatory requirements with MEDICARE/MEDICAID.
  • Knowledge of ICD9-CM, HCPCS level II and III, CPT, and revenue Codes, DRG and APC coding a plus
  • Ability to deal with complex claim issues
  • Knowledge of HMO, PPO Medicare and Medicaid plans, as well as experience with Medicare Part D
  • Advanced proficiency in Microsoft Word and Excel; Access knowledge a plus Minimum typing speed of 45 WPM and use of Ten-Key by touch
  • Knowledge of Medical terminology


• Location: Boston, Quincy, MA

• Post ID: 48885767 boston
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