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Tpl Specialist Jobs (NOW HIRING)

BerryDunn

Medicaid Payment Integrity SME

Kapolei, HI · On-site +1

... TPL specialists, data analysts, compliance staff, vendor partners, and other workstream members to help identify risks, interpret policy, improve internal controls, escalate issues for leadership ...

BerryDunn

Medicaid Payment Integrity SME

Kapolei, HI · On-site +1

... TPL specialists, data analysts, compliance staff, vendor partners, and other workstream members to help identify risks, interpret policy, improve internal controls, escalate issues for leadership ...

BerryDunn

Medicaid Payment Integrity SME

Kapolei, HI · On-site

... TPL specialists, data analysts, compliance staff, vendor partners, and other workstream members to help identify risks, interpret policy, improve internal controls, elevate issues for leadership, and ...

BerryDunn

Medicaid Payment Integrity SME

Kapolei, HI · On-site +1

... TPL specialists, data analysts, compliance staff, vendor partners, and other workstream members to help identify risks, interpret policy, improve internal controls, escalate issues for leadership ...

BerryDunn

Medicaid Payment Integrity SME

... TPL specialists, data analysts, compliance staff, vendor partners, and other workstream members to help identify risks, interpret policy, improve internal controls, escalate issues for leadership ...

BerryDunn

Medicaid Program Integrity Senior Consultant

$118K - $119K/yr

You will work as part of the BerryDunn Program Integrity team, and work closely with MQD Program Integrity staff, audit and TPL specialists, data analysts, compliance staff, vendor partners, and ...

Intellivo

Claims Recovery Specialist

Creve Coeur, MO · On-site

$47K - $52K/yr

About the Role The Claims Recovery Specialist/Legal Assistant plays a central role within a ... Answer inbound calls and emails regarding TPL claims, liens, coverage questions, and documentation ...

Intellivo

Claims Recovery Specialist

Creve Coeur, MO · On-site

$47K - $52K/yr

About the Role The Claims Recovery Specialist/Legal Assistant plays a central role within a ... Answer inbound calls and emails regarding TPL claims, liens, coverage questions, and documentation ...

Intellivo

Claims Recovery Specialist

Creve Coeur, MO · On-site

$47K - $52K/yr

About the Role The Claims Recovery Specialist/Legal Assistant plays a central role within a ... Answer inbound calls and emails regarding TPL claims, liens, coverage questions, and documentation ...

Apex Informatics

Collections Specialist

$19 - $25.50/hr

Associates degree, or related experience in lieu of degree is required.- Knowledge of SMS, HSD Diamond, and TPL module is preferred. 1-5 years of experience researching and validating commercial ...

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Tpl Specialist information

What is a TPL Specialist?

A TPL Specialist, or Third Party Liability Specialist, is a professional responsible for identifying and managing cases where a third party may be liable for a client's medical expenses. These specialists work with insurance companies, healthcare providers, and legal teams to coordinate benefits, recover costs, and ensure compliance with regulations. Their work helps reduce unnecessary spending by ensuring that the correct party pays for healthcare claims. TPL Specialists play a crucial role in Medicaid, Medicare, and private insurance settings.

What are the key skills and qualifications needed to thrive as a TPL Specialist?

To thrive as a TPL (Third Party Liability) Specialist, you need a solid understanding of insurance claims processes, legal terminology, and investigative techniques, often supported by experience in healthcare or insurance and sometimes a relevant certification. Familiarity with claims management systems, medical billing software, and legal research tools is typically required. Strong analytical thinking, attention to detail, and effective communication skills help in managing complex case files and collaborating with stakeholders. These skills ensure accurate claim handling, regulatory compliance, and optimal financial recovery for the organization.

What are the main challenges TPL Specialists face when managing third-party liability claims?

TPL Specialists often encounter the challenge of balancing large caseloads while ensuring each claim is thoroughly investigated and resolved in a timely manner. They may need to coordinate with various parties, such as claimants, legal teams, and insurance adjusters, which requires strong communication and negotiation skills. Additionally, staying updated with evolving regulations and documentation requirements is crucial for minimizing risk and ensuring compliance. The role demands attention to detail, adaptability, and the ability to handle pressure during peak periods.

What is the difference between Tpl Specialist vs Data Analyst?

AspectTpl SpecialistData Analyst
Required CredentialsTypically a degree in IT, computer science, or related field; certifications in TPL or related toolsDegree in statistics, mathematics, or related field; certifications in data analysis or visualization tools
Work EnvironmentTech companies, e-commerce, logistics, focusing on template management and customizationBusiness, finance, marketing sectors analyzing data to inform decisions
Employer & Industry UsageUsed in industries requiring template customization and managementUsed across industries for data-driven decision making

The Tpl Specialist primarily focuses on managing and customizing templates within specific platforms, often requiring technical skills and certifications. In contrast, Data Analysts interpret data to provide insights, often using statistical tools. While both roles involve technical knowledge, their core functions and industry applications differ significantly.

What cities are hiring for Tpl Specialist jobs?

Cities with the most Tpl Specialist job openings:

What states have the most Tpl Specialist jobs?

States with the most job openings for Tpl Specialist jobs include:

What are popular job titles related to Tpl Specialist jobs?

For Tpl Specialist jobs, the most frequently searched job titles are:

Third Party Liability (TPL) Specialist - Des Moines, IA - Hybrid

Des Moines, IA

Gainwell Technologies
Health Care and Social Assistance • 10K+ employees
Learn more about Gainwell Technologiesexternal

$24K - $35K/yr

Full-time

Medical, Life, Retirement, PTO

Re-posted 12 days ago

Key responsibilities

  • Research, verify, and document third-party liability (TPL) insurance coverage using multiple systems and data sources

  • Initiate and manage correspondence between Revenue Collections, insurance carriers, and the Iowa Department of Health and Human Services

  • Conduct outbound calls to insurance carriers to validate coverage and obtain claim-related information

Gainwell Technologies rating

7.9

Company rating: 7.9 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

Job description

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

Summary

As an Third Party Liability (TPL) Specialist - Des Moines, IA - Hybrid at Gainwell, you will support healthcare operations by verifying, documenting, and coordinating insurance-related information to drive accurate third-party liability (TPL) recovery efforts. This role focuses on researching and validating insurance coverage, managing correspondence with key stakeholders, and supporting workflows tied to the Iowa Medicaid contract. You will operate in a fast-paced, production- and quality-driven environment while ensuring compliance with established processes and service level agreements.

Your role in our mission
  • Research, verify, and document third-party liability (TPL) insurance coverage using multiple systems and data sources
  • Initiate and manage correspondence between Revenue Collections, insurance carriers, and the Iowa Department of Health and Human Services
  • Conduct outbound calls to insurance carriers to validate coverage and obtain claim-related information
  • Process and manage incoming faxes and emails related to TPL insurance verification requests
  • Maintain accurate and timely documentation within systems such as MMIS and OnBase
  • Identify opportunities to improve workflows and support increased recovery outcomes
  • Support project initiatives by compiling, analyzing, and reporting data as needed
  • Ensure compliance with departmental standards and contractual Service Level Agreements (SLAs)
  • Prepare and deliver periodic reports and updates to leadership
  • Perform additional duties as assigned
What we're looking for
  • High School Diploma or GED required.
  • 3+ years of experience in a professional office, healthcare, insurance, claims, or administrative environment.
  • Experience with Medicaid, insurance verification, coordination of benefits, third-party liability, claims, or healthcare operations preferred.
  • Strong working knowledge of Microsoft Office, including Excel, Word, and Outlook, with the ability to navigate multiple systems.
  • Strong attention to detail, analytical thinking, and communication skills, with the ability to manage multiple priorities in a production- and quality-focused environment.
What you should expect in this role
  • This is a hybrid role based in Des Moines, Iowa. Candidates who reside within 2.5 hours of Des Moines are encouraged to apply.
  • Required onsite training in upon hire.
  • Ongoing onsite presence required approximately 1-3 days per week to support business needs, including deposit-related activities.
  • Work is primarily performed in a professional office environment and is mostly sedentary.
  • May require extended hours based on business needs.
  • Occasional lifting of up to 10 lbs. may be required.
  • Video camera must be used during interviews and the first week of orientation.
  • Minimum internet speed of 24 Mbps download / 8 Mbps upload is required for hybrid work.

The deadline to submit applications for this posting is August 3, 2026.

The pay range for this position is $24,800.00 - $35,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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