Gainwell Technologies · 1 month ago
Casualty Case Management Specialist - Remote US
United States
Full-time
Remote
Entry Level
$25K/yr - $35K/yr
2+ years expGainwell Technologies is seeking a Casualty Case Management Specialist to manage all casualty and estate functions involving state Medicaid beneficiaries or deceased Medicaid beneficiaries. This role is responsible for the intake, maintenance, claims review, case management, settlement, and all related activities within the assigned caseload.
Health CareInformation Technology
Responsibilities
Ensure all processes meet HIPAA and government security requirements regarding the sharing and storage of Personal Health Information (PHI)
Utilize strong analytical and case management skills to oversee 700–1,000 subrogation cases simultaneously
Communicate professionally—primarily via inbound and outbound calls—with attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and clients
Prepare and manage required correspondence, liens, claims, and related documentation throughout the recovery process
Meet departmental goals for customer service, settlements, and case handling standards
Perform both basic and advanced document and legal reviews to determine case status, ensure accuracy, and support workflow progression
Verify beneficiary eligibility and maintain accurate documentation
Confirm and validate third-party liability, probate, and asset research findings
Compile and analyze information from multiple sources to determine case status and recovery potential
Process and resolve claim or lien disputes; collaborate with attorneys and relevant stakeholders as needed
Conduct periodic follow-ups on case status, payments, and settlement updates
Negotiate and finalize claim or lien settlement amounts according to established contract guidelines
Execute and file notarized documents with applicable county offices
Prioritize case events, payment issues, and revenue-impacting deadlines to ensure timely resolution
Maintain accuracy, timeliness, and productivity standards for file management and phone metrics
Qualification
Required
2+ years of relevant professional experience in subrogation, claims, or case management
Proficiency in Microsoft Word and Excel; basic knowledge of Microsoft Access is preferred
Experience in a legal or insurance office setting (paralegal, legal assistant, casualty, or health insurance experience preferred)
Familiarity with Medicaid and/or Medicare programs is preferred
Ensure all processes meet HIPAA and government security requirements regarding the sharing and storage of Personal Health Information (PHI)
Utilize strong analytical and case management skills to oversee 700–1,000 subrogation cases simultaneously
Communicate professionally—primarily via inbound and outbound calls—with attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and clients
Prepare and manage required correspondence, liens, claims, and related documentation throughout the recovery process
Meet departmental goals for customer service, settlements, and case handling standards
Perform both basic and advanced document and legal reviews to determine case status, ensure accuracy, and support workflow progression
Verify beneficiary eligibility and maintain accurate documentation
Confirm and validate third-party liability, probate, and asset research findings
Compile and analyze information from multiple sources to determine case status and recovery potential
Process and resolve claim or lien disputes; collaborate with attorneys and relevant stakeholders as needed
Conduct periodic follow-ups on case status, payments, and settlement updates
Negotiate and finalize claim or lien settlement amounts according to established contract guidelines
Execute and file notarized documents with applicable county offices
Prioritize case events, payment issues, and revenue-impacting deadlines to ensure timely resolution
Maintain accuracy, timeliness, and productivity standards for file management and phone metrics
Preferred
Basic knowledge of Microsoft Access
Experience in a legal or insurance office setting (paralegal, legal assistant, casualty, or health insurance experience)
Familiarity with Medicaid and/or Medicare programs
Benefits
Health benefits (medical, dental, and vision) begin on Day 1 of employment.
401(k) with company match and additional benefits become available within the first few months.
Employees can take advantage of the flexible vacation policy after 90 days of employment.
A company-provided computer is supplied for work use.
Company
Gainwell Technologies
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital.
10001+ employees
H1B Sponsorship
Gainwell Technologies has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (78)
2023 (56)
2022 (96)
2021 (33)
Funding
Current Stage
Late StageTotal Funding
$1M2023-06-06Grant· $1M
Leadership Team
Paul N. Saleh
President and Chief Executive Officer
Gary Call
Chief Medical Officer
Recent News
bloomberglaw.com
2025-12-12
GlobeNewswire
2025-12-11
Company data provided by crunchbase