Subrogation Professional II

Humana • Puerto Rico, TX

9d • Remote

About The Position

Become a part of our caring community and help us put health first The Subrogation Professional 2 iIdentifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health insurance. The Subrogation Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Subrogation Professional II interacts with attorneys and third-party insurance professionals to explore where there may be liability and negotiate and coordinate claim payments. The Subrogation Professional II identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health insurance. This individual ensures Coordination of Benefits (COB) records for members who have other insurance coverage are up to date. This individual responds to subrogation inquiries regarding third-party liability policies and procedures. The Subrogation Professional II conducts tasks and assignments as directed and understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. This individual makes decisions regarding their own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. This individual follows established guidelines/procedures. Use your skills to make an impact

Requirements

• Minimum 2 years experience negotiating and/or investigating, evaluating healthcare subrogation, property and casualty, or workers’ compensation matters
• Strong written and verbal communication skills; able to communicate effectively in English with attorneys and third-party insurers
• Strong organizational abilities with experience maintaining communications and case records
• Ability to manage multiple time sensitive tasks
• Excellent interpersonal skills with the ability to interact with associates at all organizational levels
• Proficiency in Microsoft Office, including creating forms, reports, and documents in Word, Excel, and OneNote
• Ability to work independently and adapt to change
• At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested
• Satellite, cellular and microwave connection can be used only if approved by leadership
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Nice To Haves

• Strong negotiation skills
• Knowledge of Medicare and Medicaid regulations relevant to the role
• Bilingual proficiency in English and Spanish, both written and verbal

Responsibilities

• Identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health insurance.
• Interacts with attorneys and third-party insurance professionals to explore where there may be liability and negotiate and coordinate claim payments.
• Ensures Coordination of Benefits (COB) records for members who have other insurance coverage are up to date.
• Responds to subrogation inquiries regarding third-party liability policies and procedures.
• Conducts tasks and assignments as directed and understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed