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Intellivo · 13 hours ago

Case Development Specialist

Creve Coeur, Missouri, United States

Full-time

Onsite

Entry Level

1+ years exp

Intellivo is an industry market leader in subrogation, empowering health plans and insurers to maximize financial outcomes. The Case Development Specialist is responsible for identifying and validating potential subrogation and reimbursement opportunities, reviewing medical claims and P&C data to ensure viable cases are set up for downstream teams.

Artificial Intelligence (AI)Health CareHospital

Responsibilities

Review claims data, P&C results, and other inputs to identify events that may give rise to subrogation or reimbursement

Apply established criteria, rules, and playbooks to determine whether a case is appropriate for creation, closure, or further review

Distinguish accident-related and third-party liability scenarios from non-recoverable or low-value situations

Create and update cases in designated systems with the appropriate parties, injury/accident information, and key claim details

Capture and summarize core facts so downstream recovery, legal, or reimbursement teams have a clear starting point

Assign case type, priority, and other attributes in accordance with guidelines and client requirements

Request and review additional information from carriers, TPAs, attorneys, or internal partners when needed to confirm case validity or clarify discrepancies

Document clarifications and decisions so that the rationale for case disposition (open, close, reclassify) is clear

Coordinate with leaders or subject matter experts on complex or borderline scenarios

Maintain accurate, complete, and well-organized case records, notes, and status fields in all applicable systems

Monitor personal queues and workload to ensure timely review and disposition of cases in line with productivity and quality expectations

Identify and correct data inconsistencies or errors that could impact downstream work or reporting

Partner with subrogation leadership and downstream operations teams (recovery, legal, reimbursement) to refine criteria and workflows

Share observations about recurring data issues, false positives, or missed opportunities to inform process or rules improvements

Participate in pilots, testing, and feedback cycles for new clients, data sources, and identification logic

Qualification

Healthcare claims experienceData analysis skillsSubrogation knowledgeMicrosoft Office proficiencyCase management platformsAnalytical skillsAttention to detailTime managementTeam collaborationFlexibility

Required

1–3 years of experience in a data-heavy environment such as claims, billing, insurance operations, revenue cycle, or similar administrative/analytic roles

Strong attention to detail and ability to maintain focus while reviewing large volumes of information

Solid analytical and pattern-recognition skills; able to apply rules and criteria consistently and spot outliers or inconsistencies

Excellent computer skills, including comfort working across multiple systems and screens

Proficiency with Microsoft Office products, especially Outlook, Word, and Excel

Ability to work both independently and in a team setting, asking questions and escalating when needed

Strong organization and time management; able to manage queues and meet throughput and quality expectations

Flexibility and comfort working in a fast-paced, changing environment