Essential Duties and Responsibilities

• Demonstrate, model and expect adherence to the company’s core values and mission.
• Perform duties in a manner compliant with company policies.
• Stay informed about changes in industry regulations and company procedures.
• Communicate clearly and professionally with internal and external stakeholders via phone, video conferencing, and email.
• Maintain confidentiality and handle sensitive information with discretion and in accordance with HIPAA
  regulations.
• Provide exceptional service to clients, members, and colleagues.
• Address and resolve issues and concerns promptly, escalating complex cases to the appropriate department or manager when necessary.
• Accurately document all interactions and transactions, ensuring that records are complete, up-to-date, and compliant with company and regulatory requirements.
• Work collaboratively with team members and other departments to achieve organizational goals.
• Contribute to a positive team environment.
• Seek opportunities for professional development and skill enhancement.
• Participate in training sessions and stay updated on industry trends and best practices.
• Prioritize tasks effectively to meet deadlines and organizational objectives.
• Identify issues and propose solutions proactively.
• Take initiative to improve processes and enhance service delivery.
• Adapt to changing priorities, projects, and work environments.
• Embrace new challenges and changes with a positive attitude.

Department Specific Responsibilities

• Review incoming lien referrals and initiate contact with applicable payers.
• Maintain accurate and timely notes, status updates, and documentation in the case management system
• Track lien amounts, dates of service, and communications from initial referral through resolution.
• Submit and follow up on requests for lien information to relevant entities including CMS, BCRC, MAP
  plans, and third-party administrators.
• Negotiate reductions or waivers where appropriate and document justification.
• Ensure compliance with legal and regulatory requirements, including HIPAA.
• Provide regular updates to referring attorneys and/or internal stakeholders regarding lien status and
  required documentation.
• Coordinate with internal departments to ensure timely settlement timelines.
• Draft and send necessary correspondence using standardized templates and communication protocols.
• Follow all internal SOPs by lien type to ensure consistency and accuracy.
• Escalate high-risk or complex cases to the Team Lead or Director of Lien Resolution as needed.
• Maintain confidentiality of sensitive member information and adhere to privacy and data security
  standards.
• Participate in training programs and department meetings.
• Collaborate with peers to improve department-wide processes and resolve operational bottlenecks