Remote Subrogation Specialist: Claims & Recovery

Humana Inc; City of Albany (NY); A distancia; USD 59.000 - 68.000; Jornada completa

Descripción de la vacante

Humana Inc. is seeking a Subrogation Professional 2 to investigate accident and claim events to determine Humana’s right to recover payments.

The role gathers details from members, providers, adjusters, attorneys, and other parties, reviews payments, creates liens, and negotiates repayment where appropriate. This remote role reports to a Supervisor and requires 2+ years of subrogation experience, strong communication, and MS Office proficiency.

Formación

• 2+ years of subrogation claims handling experience in healthcare, property and casualty, or worker's compensation insurance
• 2+ years phone customer service experience dealing with escalated situations involving attorneys, providers, and/or members
• Microsoft Office proficiency — ability to create forms, reports, and documents in Word and Excel
• Experience multitasking within several computer systems throughout the day
• Strong verbal and written communication skills
• Basic proficiency with computers, email, phone systems, and data entry

Responsabilidades

• Review new accident, injury, or claim events to determine whether subrogation or other party liability may apply
• Contact members, providers, insurance adjusters, attorneys, and other involved parties by phone or email to gather claim details
• Investigate the facts of the accident or claim, including: What happened; Date and location; Who was at fault; All parties involved; Insurance coverage information; Attorney or legal representation information; Settlement status, when applicable
• Use available resources to support the investigation, such as police reports, state websites, claim systems, provider information, and other approved resources
• Identify and document responsible parties and provide notice of Humana’s potential recovery interest
• Review claim payment information to determine amounts paid by Humana related to the accident or claim
• Create, update, and maintain liens based on eligible paid claims
• Communicate lien information to attorneys, adjusters, and other appropriate parties
• Negotiate lien repayment amounts with attorneys or other parties as needed
• Document all conversations, research, actions taken, decisions made, and claim updates in the appropriate systems
• Follow up on outstanding claims, liens, documentation, settlement information, and recovery opportunities
• Balance daily workload and create an effective workflow to manage competing priorities
• Manage a high-volume workload while meeting monthly productivity, quality, and recovery expectations
• Use multiple computer systems and applications to research claims, document activity, and complete daily work
• Work independently while knowing when to elevate complex issues or seek guidance

Conocimientos

Subrogation

Customer service

Microsoft Office

Multitasking

Communication

Educación

Undergraduate degree

Descripción del empleo

Humana Inc. is seeking a Subrogation Professional 2 to investigate accident and claim events to determine Humana’s right to recover payments.

The role gathers details from members, providers, adjusters, attorneys, and other parties, reviews payments, creates liens, and negotiates repayment where appropriate. This remote role reports to a Supervisor and requires 2+ years of subrogation experience, strong communication, and MS Office proficiency.