Lien Specialist

Company: Keenan
Location: Torrance
Posted on: June 22, 2022

Job Description:

AP Keenan, an AssuredPartners company, is a successful insurance brokerage and consulting firm meeting the insurance needs of hospitals, public entities and California school districts. AP Keenan specializes in providing consulting services in the areas of: employee benefits, workers' compensation, loss control, financial, and property & liability. We have seen continuous growth and success, and are positioned to lead the industry into the 21st century. Together, with AssuredPartners, we continue to grow at a rapid pace, and so do the opportunities for our current and future employees.This is a hybrid position.SUMMARY: Resolves liens in accordance with statutory and case law as well as pertinent regulations, understands lien management, negotiations, Official Medical Fee Schedule, Medical Provider Networks and the Workers' Compensation litigation process.ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

• Caseload includes a variety of post-settlement liens, review only requests and review of bills.
• Reviews and negotiates liens from medical providers, EDD, interpreters, copy service companies and others.
• Ascertains validity of each lien and appropriate defenses.
• Communicates with lien claimants to resolve liens.
• Organizes and keeps record of on-going lien settlement negotiations, resolution and invoicing for services performed.
• Manages and recommends payment of settled liens.
• Confers with legal counsel/claims examiner on liens that require litigation.
• Obtains necessary documents (evidence) to defend lien claim should litigation be required.
• Reports underpayments, overpayments and other irregularities.
• Reports potentially fraudulent activity to internal SIU.
• Resolves liens fairly and equitably, acting in the best interest of the insured and providing benefits as prescribed by law.
• Understanding of the California Official Medical Fee Schedule (OMFS) to provide current and accurate information.
• 100% documentation is expected for each lien received with communication to referring party.
• Escalated issues should be followed up within five (5) business days of receipt.
• Request additional information from external sources when required.
• Review complex or unusual claim situations.
• Review claims previously processed incorrectly and forward to designated personnel with recommended corrective actions.
• Perform claim processing/adjustments in production with 100-125 expected per day.
• Research claims status.
• Other duties as assigned.MINIMUM SUGGESTED QUALIFICATIONS:
  • Minimum three (3) years customer service background with knowledge of Lien Claims, Workers' Compensation and health insurance benefits required, five (5) years preferred.
  • Must have a California Medical Bill Reviewer designation, or the ability to pass the California Medical Bill Review exam within six (6) months of hire.
  • IEA 101 and Medical Terminology courses helpful.
  • Excellent verbal and written communication skills. SOFTWARE: Proficient in Microsoft Outlook, Excel, PowerPoint and Word. Adept at accessing business data from the Internet when required.

Keywords: Keenan, Torrance , Lien Specialist, Other , Torrance, California