Subrogation Recovery Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Evaluate and recover funds associated with accidents, injuries, or illnesses for which another party is accountable.

• Collaborate with attorneys, health carriers, adjusters, and other stakeholders to expedite and optimize settlements.

• Oversee cases from initiation to recovery while maintaining current and precise notes.

• Provide timely and accurate information to facilitate case progression through the workflow.

• Verify beneficiary eligibility documentation.

• Review and update case documents as necessary.

• Confirm and validate third-party liability, probate, and beneficiary asset research.

• Engage professionally with attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and clients.

• Draft correspondence, liens, claims, and related recovery documents.

• Negotiate and settle claim/lien amounts in accordance with contractual guidelines.

• Handle claim/lien disputes and review claims with attorneys and stakeholders.

• Periodically follow up on case status and payments.

• Conduct document reviews, legal research, and manage cases efficiently.

• Prioritize key case events and payment/recovery issues while adhering to internal and legal deadlines.

• Compile and analyze case information from various sources to draw relevant conclusions.

• Meet departmental customer service standards.

• Prepare periodic management reports.

• Ensure compliance with HIPAA and government security requirements for PHI.

• Act as an escalation point for the project team when necessary.

• Support project-specific training needs.

• Develop training templates, application training, training materials, and user job aids.

• Coordinate with product teams to keep training materials up to date.

• Complete performance review responsibilities, special projects, and other assigned tasks.

⛳️ Requirements

• High School Diploma or GED is mandatory.

• Minimum of 3 years of relevant experience.

• Experience in a legal office is advantageous; paralegal or legal assistant experience and/or casualty or health insurance experience is preferred.

• Proficiency in Microsoft Excel and Word is essential.

• Basic computer skills, including typing and navigating various websites, are required.

• Ability to analyze information and apply logic to resolve work-related issues, problems, or opportunities.

• Capable of delivering presentations of good quality.

• Ability to work independently to achieve objectives.

• Ability to thrive in a team environment.

• Strong verbal and written communication skills are necessary.

• Detail-oriented and thorough in work execution.

• Professional interaction with internal and external stakeholders is crucial.

• Working knowledge of HIPAA privacy and security regulations is required.

• Ability to maintain confidentiality and uphold ethics is essential.

• A solid understanding of the subrogation industry is required.

• Familiarity with interpreting an Explanation of Benefits (EOB), UB-04, Form 5500, Summary Plan Description (SPD), Master Plan Document (MPD), and Evidence of Coverage (EOC) is preferred.

• Knowledge of Medicaid and/or Medicare is advantageous.

• Ability to organize information for necessary parties is required.

• Capability to manage pressure, meet project deadlines, and multitask on a caseload is essential.

• Bilingual in Spanish and English is a plus.

• Must be able to provide a dedicated, secure workspace.

• Must have access to high-speed internet and ensure office setup and maintenance.

• Must be able to perform duties with or without reasonable accommodation.

🏝️ Benefits

• Discretionary bonus opportunity.

• Overtime pay for hours worked beyond 40 hours per week, or as mandated by applicable state law.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Disability insurance coverage.

• Life insurance coverage.

• 401(k) savings plan.

• Paid family leave.

• 9 paid holidays each year.

• 17-27 days of Paid Time Off (PTO) annually, based on level and duration of service.