Subrogation Specialist

Claritev•New York, NY

3h•Onsite

About The Position

Process a paperless health insurance subrogation caseload by investigating and developing subrogation case facts and sources of recovery. Responsibilities include placing a large volume of outbound calls as well as submitting correspondence to health plan members, insurance companies, and attorney offices. The Subrogation Specialist will coordinate efforts with other members of the subrogation team to maximize recovery in accordance with Subrogation Policies and Procedures.

Requirements

Minimum high school diploma or GED coupled with at least one (1) year of relevant experience.
Working knowledge of Microsoft Word, Excel, internet research skills
Excellent organizational, communication, critical thinking, analytical and independent decision making skills
Developed customer service skills
Strong organizational and time management skills
Ability to work independently and as part of a team
Required licensures, professional certifications, and/or Board certifications as applicable
Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone

Responsibilities

Learn and understand fundamentals of health insurance subrogation, including basic health plan contractual provisions that apply to the reimbursement efforts.
Review, identify and develop subrogation opportunities by gathering missing information and potential sources of recovery.
Place parties of interest on notice.
Organize and structure investigations to work in priority order using the tools provided.
Respond timely to all electronic, written and verbal communications.
Log and maintain detailed and accurate records.
Access and pull benefits from clients' health claim systems.
Engage advice and/or help of legal manager to proactively resolve cases.
Ensure compliance of state and federal laws.
Provide feedback to management and unit on trends or developments.
Collaborate, coordinate, and communicate across disciplines and departments.
Ensure compliance with HIPAA regulations and requirements.
Demonstrate Company's Core Competencies and values held within.
Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

Benefits

Medical, dental and vision coverage with low deductible & copay
Life insurance
Short and long-term disability
Paid Parental Leave
401(k) + match
Employee Stock Purchase Plan
Generous Paid Time Off – accrued based on years of service
WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
10 paid company holidays
Tuition reimbursement
Flexible Spending Account
Employee Assistance Program
Sick time benefits – for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits