Case Development Specialist - Health Insurance Plan Recovery

divh2Case Development Specialist Healthcare Recovery/h2pThe Case Development Specialist Healthcare Recovery reviews inbound referrals and manually screens claims data to identify potential reimbursement and subrogation opportunities for Intellivos clients. This role focuses on intake, validation, and case setupensuring that only high-quality, recoverable matters move forward to downstream recovery and legal teams. You will analyze medical claims, property casualty (PC) referrals, and related documentation to determine recovery potential, clarify facts, and accurately create cases in internal systems./ppThis role is ideal for candidates with backgrounds in insurance claims intake, medical billing, revenue cycle operations, or payer intake functions who enjoy investigative review, accuracy-driven work, and high-impact decision-making./ppResponsibilities:/pulliReview inbound referrals, accident reports, and insurer-supplied data for recovery potential/liliManually screen healthcare claims and PC information to identify third-party liability or reimbursement opportunities/liliApply intake rules and guidelines to determine case creation, closure, or escalation/liliDistinguish recoverable accident-related scenarios from non-recoverable or low-value claims/li/ululliCreate and update cases in internal systems with accurate parties, injury details, and claim data/liliCapture and summarize referral facts for recovery and legal teams/liliAssign case types, priorities, and attributes based on client requirements/li/ululliRequest additional documentation from carriers, TPAs, attorneys, or internal teams to validate referrals/liliDocument decisions and intake rationale clearly/liliEscalate complex or borderline cases to subject-matter experts/li/ulpQualifications:/pulli13 years experience in insurance claims intake, medical billing, revenue cycle, payer operations, or data-review roles/liliAssociates or Bachelors degree preferred (or equivalent experience)/liliFamiliarity with healthcare claims, PC data, TPL, or subrogation a plus/liliStrong attention to detail and investigative mindset/liliComfortable performing high-volume manual review across multiple systems/liliProficiency with Microsoft Office/liliOrganized and able to manage intake queues independently/liliCollaborative and comfortable escalating questions/li/ulpWho is Intellivo?/ppAs an industry market leader in subrogation, Intellivo empowers health plans and insurers to maximize financial outcomes by identifying and pursuing more reimbursement opportunities from alternative third-party liability (TPL) payers. Through innovative technology, Intellivo accelerates the identification of reimbursement opportunities while completely eliminating the need to fill information gaps through ineffective and burdensome outreach to plan members. With a 25-year history of excellence, Intellivo proudly serves more than 200 of the countrys largest health plans./ppWhy work for Intellivo?/pulliAmazing Team Members Intellivators!/liliMedical Insurance/liliDental Vision Insurance/liliIndustry leading health wellness benefits/lili401(K) retirement plan/liliCompetitive Paid Time Off/liliAnd More!/li/ul/div