Case Development Specialist - Health Insurance Plan Recovery

About the Role

The Case Development Specialist – Healthcare Recovery reviews inbound referrals and manually screens claims data to identify potential reimbursement and subrogation opportunities for Intellivo’s clients. This role focuses on intake, validation, and case setup—ensuring that only high-quality, recoverable matters move forward to downstream recovery and legal teams. You will analyze medical claims, property & casualty (P&C) referrals, and related documentation to determine recovery potential, clarify facts, and accurately create cases in internal systems.

This 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.

Responsibilities:

Referral Intake & Manual Review

Review inbound referrals, accident reports, and insurer-supplied data for recovery potential

Manually screen healthcare claims and P&C information to identify third-party liability or reimbursement opportunities

Apply intake rules and guidelines to determine case creation, closure, or escalation

Distinguish recoverable accident-related scenarios from non-recoverable or low-value claims

Case Setup & Data Entry

Create and update cases in internal systems with accurate parties, injury details, and claim data

Capture and summarize referral facts for recovery and legal teams

Assign case types, priorities, and attributes based on client requirements

Information Gathering & Coordination

Request additional documentation from carriers, TPAs, attorneys, or internal teams to validate referrals

Document decisions and intake rationale clearly

Escalate complex or borderline cases to subject-matter experts

Qualifications:

1–3 years’ experience in insurance claims intake, medical billing, revenue cycle, payer operations, or data-review roles

Associate’s or Bachelor’s degree preferred (or equivalent experience)

Familiarity with healthcare claims, P&C data, TPL, or subrogation a plus

Strong attention to detail and investigative mindset

Comfortable performing high-volume manual review across multiple systems

Proficiency with Microsoft Office

Organized and able to manage intake queues independently

Collaborative and comfortable escalating questions

Who is Intellivo?

As 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 country’s largest health plans.

Why work for Intellivo?

Imagine a place where your talent is treasured, and excellence is rewarded. Now imagine a collaborative culture where every voice is valued. We are a team united by solving some of the most complex challenges on the financial side of healthcare.

Amazing Team Members – Intellivators!

Medical Insurance

Dental & Vision Insurance

Industry leading health & wellness benefits

401(K) retirement plan

Competitive Paid Time Off

And More!