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Job Summary

Company
SCIO Health Analytics
Location
Pittsburgh, PA 15205
Industries
Healthcare Services
Job Type
Full Time
Employee
Years of Experience
2+ to 5 Years
Education Level
Bachelor's Degree
Career Level
Experienced (Non-Manager)

Subrogation Specialist

About the Job

SCIO Health Analytics is a leading health analytics services organization providing actionable analytics driven solution for health plans, care management organizations, life science, large employers, and PBMs. With an extensive roster of 30+ clients including 15 of the Top 25 health plans that serve more than 70 million consumers, SCIO Health Analytics' solution set includes payment integrity and analytic solutions, care management analytics, health consumer analytics and provider and network analytics that help health payers and risk-bearing entities eliminate or avoid payment errors, reduce administrative and medical costs, increase consumer engagement, increase revenues through new products and services, and measurably improve outcomes. All of SCIO Health Analytics' solutions are built on strong integration of the Big Data from multiple sources that exist within the healthcare eco system and the health organization.

SCIO Health Analytics' delivery model is highly flexible with SaaS, analytics, outcomes-driven end-to-end services, technology platforms and advisory.

Specialties

Healthcare Big Data Analytics, Payment Integrity, Value based benefit design analytics, Care and Health analytics, Data mining, DRG and clinical audits


General Description:


This employee will review injury claims, analyze situations for liability and recovery potential, review state and federal regulations, pursue recovery from responsible third parties and insurance carriers, negotiate effective settlements, and communicate with a wide range of parties including members, medical providers, attorneys and insurance carriers.

Responsibilities:
  • Prior experience in healthcare subrogation, property casualty insurance, workers compensation or law office work related to healthcare claims.
  • Applicants with experience that demonstrates attention to detail.
  • Ability to communicate with a diverse range of customers and an ability to learn on the job.
  • Proven ability to manage various types of projects.
  • This employee must take the initiative to make things happen rather than reacting to situations.
  • Creative/lateral thinking – ability to identify alternative paths for investigating files and identify less obvious potential recovery sources.
  • Perseverance – try alternatives when first efforts fail.
  • Decision making – ability to make sound and timely decisions.

 

Qualifications:

         

         

    • An associate degree with 2-3 years of administrative experience.
    • Bi-lingual (Spanish) is a plus.

 


   


To learn more about us, visit us at www.sciohealthanalytics.com

 
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