Subrogation Coordinator

Zenith American Solutions•Las Vegas, NV

About The Position

The Subrogation Coordinator supports the resolution of complex subrogation claims, ensuring accuracy, efficiency, and compliance with all regulatory and plan-specific requirements. This role assists with complex cases, shares knowledge with team members, and contributes to process consistency and team collaboration. "Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role."

Requirements

High School Diploma or GED.
Three years of progressively responsible experience in subrogation, claims processing, or a related healthcare or insurance environment.
Advanced knowledge of subrogation workflows, third-party liability, and relevant federal and state regulations.
Excellent written and verbal communication skills with the ability to interface effectively with attorneys, external stakeholders, clients, and internal teams.
Strong analytical thinking, organizational skills, and attention to details.
Strong working knowledge of claims adjudication processes and the ability to identify recoverable claims through comprehensive case analysis.

Nice To Haves

Associate’s degree in business, Healthcare Administration, Legal Studies, or a related field.
Experience working in a multi-client or third-party administrator (TPA) environment.
Familiarity with lien resolution, legal negotiations, or settlement processes related to third-party liability claims.
Prior experience supporting audits, process improvements, or system implementations in a subrogation or claims department.

Responsibilities

Handles a high-volume caseload of complex or high-priority subrogation claims, including third-party liability and workers’ compensation cases.
Conducts in-depth claim analysis to determine subrogation potential and recovery opportunities, ensuring alignment with legal standards and plan requirements.
Coordinates with attorneys, insurance carriers, third-party administrators, and internal stakeholders to facilitate resolution of disputed or litigated cases.
Oversees the preparation and accuracy of detailed reports for leadership, clients, and legal counsel; identify trends and make strategic recommendations.
Provides subject matter expertise on departmental procedures, regulatory compliance, and best practices related to subrogation.
Conducts quality assurance reviews to ensure adherence to departmental standards and plan-specific guidelines.
Supports internal audits, compliance reviews, and risk mitigation efforts through documentation verification and data analysis.
Monitors regulatory and industry developments impacting subrogation and recommend policy or procedural updates as needed.
Responds to inquiries from attorneys, participants, providers, and plan representatives with professionalism, discretion, and expertise.
Acts as a subject matter expert on subrogation policies, regulatory requirements, and departmental protocols, ensuring consistency and compliance in complex case handling.
Assists team development by providing ongoing mentorship, technical guidance, and expertise in navigating challenging or high-impact subrogation claims.
Participates in process improvement projects, collaborating with management to enhance operational workflows and system functionality.
Performs other duties as assigned.