Other Party Liability - Subrogation Coordinator

Find out exactly what skills, experience, and qualifications you will need to succeed in this role before applying below.

Remote from WA, OR, ID, and UT

Primary Job Purpose

This position is responsible to pursue the Company's rights of subrogation and recovery to determine the Company's course of action in accidental, medical malpractice, and occupational injury claims and seek resolution of subrogation and recovery cases.

Responsibilities require accurate and excellent desk and case management skills, interacting with members, and attorneys, with the goal of maximizing Company's recovery of claims payments advanced in third-party conditions.

General Functions and Outcomes

Determine and execute the Company's most advantageous course of action to recover claims payments advanced for third-party conditions.

Administer and communicate the Company's position regarding contract exclusions and subrogation / recovery provisions.

Analyze,and discuss with attorneys, insurance companies, insurance agents, brokers and members the resolution of subrogation / recovery interests to obtain maximum recovery of benefits paid in accordance with contract language.

Review, approve, and send subrogation files to internal and external collection agency for collection, to include answering inquiries and correspondence regarding disputed accounts.

Handle cases with efficiency and understanding up to $10000 value.

Keep management and in-house counsel appraised of group and contract developments that impact recovery of claims payments advanced for third party conditions.

Develop and maintain subrogation procedures for identifying subrogation cases, including recommendation and / or implementation of policy and procedural changes to improve unit productivity and third-party reimbursements, to include periodic review and update of all third-party "form" documents.

Open cases and put appropriate parties on notice.

Respond to telephone and written inquiries from attorneys, insurance companies, groups, providers, and members regarding subrogation, Workmen's Compensation, no-fault, and collection issues.

Maintain a high case load, updating subrogation lists from claims histories and providing attorneys and adjusters with current subrogation totals to make certain the Company's interests are protected at time of settlement.

Each file is reviewed at least four times a year.

Provide copies of claims at the request of attorneys to ensure that our members and / or attorneys have full knowledge of benefits paid on the behalf of our subscribers.

Utilize corporate file management, reporting, and savings tracking systems as required per standards established by the Company.

Establish effective business relationships with internal and external business partners.

Minimum Requirements

Strong analytical and decision making skills

Strong organizational, problem-solving, time-management skills with the ability to manage workload independently.

Excellent relationship-building skills and be able to assist members, their attorneys, and other external and internal customers in navigating the health care system and understanding their obligations related to their health plan contract.

Ability to exercise initiative and independently make decisions within the scope of assigned authority and to assume responsibility while operating with a minimum of supervision

Ability to work as part of a team and demonstrate efficiency in caseload management and recovery maximization, working with a high volume of cases and keeping detailed and accurate records

Ability to meet established deadlines, to triage and be flexible in evaluating competing priorities, and be responsive, available, and timely

Demonstrated proficiency with a PC, including working knowledge of Word, and Excel

Normally to be proficient in the competencies listed above

The Subrogation Coordinator would have a Bachelor's degree in a business related field and 1-2 years of experience in Other Party Liability investigations and accident review or equivalent combination of education and experience.

Work Environment

Travel may be required, locally or out of state.

May be required to work outside normal hours.

LI-Remote

Last updated : 2024-03-27