The Phia Group provides, amongst other things, claim recovery services for health benefit plans. When a health benefit plan pays medical bills, and we later discover someone else should have paid those medical bills, The Phia Group – on behalf of the health plan – will seek to recover the funds. The Case Investigator plays an important role in this effort, by determining whether another proper payer exists, and obtaining the details needed to pursue fund reimbursement.

As the Mass Tort Team Leader you will act as the subject matter expert and operational lead for the Phia Mass Tort program and team. Lead the implementation and subsequent relationship for mass tort clients while remaining focused on documentation and all-around efficient mass tort specific processes. This role will play an integral part in the expansion of the mass tort product and team.

At The Phia Group, whose mission is to provide high quality yet affordable healthcare to American employees and their dependents, you can look forward to not only exceptional benefits for yourself but also being immersed in a company that has been named one of USA Today’s top workplaces for 2024. We believe that this distinction, which stems from the fourth-annual survey co-sponsored by Energage and USA Today, reflects our unwavering commitment to upholding an internal culture of inclusivity, enjoyment, and empathy for our valued employees.

Key Responsibilities

Compile and maintain detailed terminology dictionary for product line Master Phia mass tort recovery processes Manage implementation of unique conditions new to the program Coordinate with technology teams on mass tort environment enhancements Create and maintain program specific electronic training documents Train new team members on all department best practices and procedures Develop and maintain relationships with HRS and any subsequent mass tort partners Maintain a working knowledge of applicable laws Have a working knowledge of all subrogation reports Expert level knowledge of all reporting used for the mass tort program Identify and implement process automation and efficiency for the mass tort program Participate in onboarding of new technologies used in the recovery department Provide day to day management of the mass tort team Maintain internal and external communications, including meetings and documentation of the same Develop and maintain a lien resolution firm process Lead RX data collection campaigns Assist VP & SVP of Recovery on special project work

Experience and Qualifications

5+ years healthcare subrogation experience Working knowledge of Tableau a plus HIPPA awareness and compliance Extensive knowledge and understanding of the skills needed to perform excellent internal and external customer service High School Diploma or equivalent Excellent attention to detail with the ability to multi-task Advanced communication skills both verbal and written Mastery of Microsoft office suite of products (Excel, Work, etc.) Outstanding organizational, interpersonal, and presentation skills Must be self-motivated and able to meet multiple project deadlines Advanced understanding of multiple healthcare payor systems ICD-9/ICD-10 knowledge Willingness to obtain certifications as the business need arises 3 to 5 years Mass Tort and Class Action case management experience

The Phia Group’s Commitment to Diversity

The Phia Group is committed to creating a diverse environment and we are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. The Phia Group is also committed to compliance with all fair employment practices regarding citizenship and immigration status.

Working Conditions / Physical Demands
Sitting at workstation for prolong periods of time. Extensive computer work. Workstation may be exposed to overhead fluorescent lighting and air conditioning. Fast paced work environment. Operates office equipment including personal computer, copiers, and fax machines.

This job description is not intended to be and should not be construed as an all-inclusive list of all the responsibilities, skills or working conditions associated with the position. While it is intended to accurately reflect the position activities and requirements, the company reserves the right to modify, add or remove duties and assign other duties as necessary.

External and internal applicants, as well as position incumbents who become disabled as defined under the Americans with Disabilities Act, must be able to perform the essential job functions (as listed here) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis.