Medicaid Caseworker - Remote US (Any city, TX, US, 99999)

Summary

HMS makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people have access to healthcare—now and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, increase quality, and achieve regulatory compliance. We also help consumers take a more active role in their own health. Each year, we save our clients billions of dollars while helping people live healthier lives. At HMS, you will develop new skills and build your career in a dynamic industry while making a difference in the lives of others.
We are seeking a talented individual for a Senior Subrogation Case Worker role, who is responsible for processing all probate and estate functions involving several state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes intake, maintenance, claims review and selection, asset investigation, court filings and deadline management, settlement and other related functions to the case.

Your role in our mission

• Interact professionally (i.e. on incoming and outgoing calls) with attorneys, court staff, recipients and family members and client.
• Effectively maintain and manage a variety of cases with current and accurate notes from creation to recovery.
• Maintain a daily system of providing timely and accurate information required to move cases through the case management workflow.
• Daily telephone contact with counterparties, including attorneys and healthcare providers.
• Confirm and validate third party liability and, probate and beneficiary asset research.
• Prepare required correspondence, liens, claims and other related documents to progress the case to recovery.
• Negotiate and compromise claim/lien settlement amounts per contract guidelines.
• Process all claim/lien disputes and review claims with attorneys and other stakeholders.
• Conduct outgoing follow up on case status and payment.
• Perform basic and advanced levels of document review to identify current case status, legal research, and case management and ensure case progress through workflow
• Prioritize case events and critical case payment/recovery issues, while meeting, various internal and legal deadlines that are revenue impacting.
• Compile, analyze and make conclusions about case information and status from multiple sources.

What we're looking for

• High school diploma or GED.
• Experience working in a legal office, Medicaid office, or similar professional environment.
• Experience as a paralegal, legal assistant, county caseworker, county technician, or in a comparable role.
• Experience reviewing or interpreting real estate documents.
• Proficiency in Microsoft Outlook, Word, and Excel.

What you should expect in this role

• This is a remote position in USA.
• Work schedule is Monday – Friday, from 8-5 PM
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.
• To test your internet speed, go to Google and search for “Internet Speed Test.”

The deadline to submit applications for this posting is July 29, 2026.