Subrogation Negotiator

Claritev; United States; On-site; USD 46,000 - 62,000; Full time

Benefits offered by this job

Health insurance

401(k) plan

Bonus opportunity

Job summary

Claritev in the United States seeks a Subrogation Specialist to manage a paperless healthcare subrogation caseload, coordinating with attorneys to recover health plan funds. You will negotiate reimbursements of liens, track claim payments across related parties, and ensure HIPAA-compliant handling of sensitive data.

This role requires strong negotiation, legal environment experience, and detail-oriented work in a team setting.

Qualifications

• High school diploma plus 4 years in a legal environment, with 3 years in negotiation.
• Paralegal certificate preferred.
• Proficiency in Word, Excel, and online research.

Responsibilities

• Conduct due diligence and preserve lien rights.
• Negotiate health plan settlements.
• Maintain accurate records and communicate with management.
• HIPAA compliance awareness and privacy sensitivity.

Skills

Attention to detail

Communication skills

Professionalism

Team player

Hands-on attitude

Education

High school diploma

Paralegal certificate preferred

Bachelor’s degree preferred

Tools

Microsoft Word

Microsoft Excel

Internet research

Job description

Job Description

JOB SUMMARY: This role manages a “paperless” healthcare subrogation case load through investigation, pending and settlement stages of the recovery process. The work environment is team oriented; the incumbent will coordinate efforts with the team and attorneys to bring matters to efficient and successful outcomes. The incumbent’s primary responsibility will be negotiating reimbursement of the health plan’s lien on settlement proceeds and is accountable for managing the coordination of claim payments among health plans and other responsible parties through recovery of 1st and 3rd party funds.

Job Roles And Responsibilities

• Conduct due diligence (e.g. online research, insurance verification, and court record searches) to assist with collections and preservation of lien rights
• Work all aspects of the recovery process following client specific procedures and guidelines, and maintain a calendar diary to monitor case activity, and provide feedback to management and unit on trends or developments
• Negotiate health plan medical claim settlements
• Identify and develop subrogation opportunities and place parties of interest on notice
• Respond timely to all electronic, written and verbal communications, log information derived from written and verbal communication; where required maintain detailed and accurate records
• Research and request case information to develop cases, access and pull benefits from clients’ remote health claim systems
• Pursue worker’s compensation, third party liability, first party uninsured and underinsured recovery, worker’s compensation, med-pay coverage and no-fault recoveries
• Understand basic health plan contractual provisions and apply to the reimbursement efforts, ensure compliance of state and federal laws and settlement authority levels
• Maintain department productivity and quality standards
• Sensitivity to privacy in accordance with HIPAA guidelines
• 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.

JOB SCOPE:

Keep the needs of external and internal customers as a priority when making decisions and taking action. Operates independently under limited supervision. Has decision making authority within specified parameters and must engage advice and/or help of legal manager to proactively resolve cases. Works across customers, beneficiaries, providers, and supplemental payors while maintaining positive relationships.

JOB REQUIREMENTS (Education, Experience, And Training)

• Minimum high school diploma coupled with at least four (4) years’ experience in a legal environment, three (3) of which should be inclusive of direct experience in negotiation. Bachelors’ degree in a relevant field is preferred.
• Paralegal Certificate Preferred
• Proficiency with Microsoft Word, Excel, internet research skills
• Good judgment, discretion, maturity, professionalism, and razor-sharp attention to detail.
• Excellent written and communication skills.
• A "roll-up your sleeves" attitude, and team player mindset are must haves for this position.
• Aptitude for navigating complex issues.
• Skilled at identifying and summarizing red flags/key risks.
• Ability to navigate through ambiguity and thrive in a fast-paced, dynamic environment while juggling priorities and deadlines.
• 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.

Compensation

The salary range for this position is 46K-62K. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.

About Us

Why Claritev?

Healthcare is complex. We help make it clearer.

At Claritev, you'll do work that matters. Together, we're helping make healthcare more transparent and affordable for all through the power of data, technology, and expertise. We offer meaningful opportunities to grow your career, collaborate with talented colleagues, and make an impact on the clients and communities we serve. If you're looking for purpose, growth, and a team that succeeds together, you'll find it here.

What Guides Us

At Claritev, innovation, agility, and a focus on results drive our success. We embrace bold thinking, work as one team, take ownership, and strive for excellence in everything we do — creating meaningful impact for our clients, communities, and each other.

About The Team

My Total Value

Claritev’s Global Total Rewards Philosophy — My Total Value — Is Grounded In Investing In Our Associates And Rewarding Performance. This Includes

• Competitive compensation and incentive opportunities (where eligible)
• Medical, dental, and vision coverage
• Life and disability coverage
• 401(k) with company match
• Employee stock purchase plan
• Flexible spending accounts and health savings accounts
• Paid time off and company holidays
• Paid parental leave
• Mental health resources
• Tuition reimbursement
• Financial planning resources
• Professional development opportunities

Our Commitment to Inclusion

At Claritev, we believe diverse perspectives strengthen our teams and lead to better outcomes. We are committed to fostering an inclusive workplace where every associate feels respected, valued, and empowered to succeed.

Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law.