⦁ Subrogation Analyst handling United Healthcare accounts in negotiating settlements on behalf of Optum which result in the recovery savings of $356 million annually for the company for FY, 2014, 2015, and 2016.
⦁ Provide conflict resolution with financial settlement agreements between United Health Care, plan members, and Attorneys to ensure proper plan reimbursements for all services.
⦁ Create and update medical payment summaries including plan language to ensure accuracy in reporting all related medical claims and legal reimbursement rights.
⦁ Investigate, recover, and resolve all types of claims as well as recovery and resolution for health plans, commercial customers, and government entities.
⦁ Initiate phone calls to members, providers, and other insurance companies to gather coordination of benefits.
⦁ Investigate and pursue recoveries and payables on subrogation claims and file management.
Process recovery on claims.
⦁ Ensure adherence to state and federal compliance policies, reimbursement policies, and contract compliance.
⦁ Absolute HIPAA compliance
⦁ Sr. Collection Agent and main point of contact, for escalated call complaints, and responsible for skip tracing new account information, to locate delinquent borrowers to ensure proper collection procedures were tried prior to implementing garnishment process.
⦁ Provided guidance and educated borrowers on rehabilitation payment programs which resulted in the settlement of accounts, and contributed to department recovery goals of $3.5 million annually.
⦁ Collection of debts for the Department of Education and responsible for the management of over 200 accounts at any given time.
⦁ Team building exercises to encourage cooperation and talk off opportunities for increase of successful contacts with borrowers.
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