Case Development Specialist

About the Role

The Case Development Specialist is responsible for identifying and validating potential subrogation and reimbursement opportunities for Intellivo’s clients. This role reviews medical claims, property & casualty (P&C) data, and related information to determine whether recovery potential exists and ensures viable cases are accurately set up for downstream teams. 

The Case Development Specialist serves as a critical quality and triage function—confirming case validity, clarifying key facts, and improving the accuracy and value of the subrogation pipeline. 

Responsibilities:

Case Identification & Assessment 

• 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

Case Setup & Enrichment 

• 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

Information Clarification & Coordination 

• 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

Data Quality, Documentation & Throughput 

• 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 

Collaboration & Continuous Improvement 

• 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 

Qualifications:

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

• Associate's or Bachelor's degree preferred but not required; equivalent experience considered

• Experience working with healthcare claims, P&C data, or subrogation is a plus but not required 

• 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
• Experience with healthcare claims data, P&C databases, or other analytic tools
• Prior experience in subrogation, claims, or revenue cycle environments
• Experience using case management platforms or rules-based triage/queue systems

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!

*Benefit Recovery Group has been renamed Intellivo.