Subrogation Specialist
MotivHealthSouth Jordan, UT, United States5 days ago
Job type
- Full-time
Job descriptionAssociate or bachelor's degree in business, legal studies, insurance, or a related field preferred. 2+ years of experience in subrogation, claims recovery, or health insurance preferred. Strong understanding of subrogation principles, health insurance claims, and related regulations (e.g., HIPAA, ERISA). Exceptional analytical, negotiation, and problem-solving skills. Proficiency in claims management software and Microsoft Office Suite. Excellent written and verbal communication skills. Detail-oriented with the ability to manage multiple cases simultaneously. Legal and Regulatory Knowledge : Familiarity with insurance laws and subrogation processes. Negotiation : Ability to secure favorable settlements with third parties. Customer Service : Professional interaction with external stakeholders, including insured members and legal representatives. Organizational Skills : Maintain high productivity and efficiency in managing multiple cases.
Position Summary
The Subrogation Specialist is responsible for identifying, investigating, and pursuing subrogation opportunities to recover costs on behalf of MotivHealth. This role involves collaborating with claims teams, legal departments, and external parties to ensure accurate and efficient recovery of funds while maintaining compliance with state and federal regulations.
Key Responsibilities
- Case Identification and Investigation
- Review claims to identify potential subrogation opportunities related to accidents, worker's compensation, liability claims, or third-party negligence.
- Gather and analyze relevant information such as police reports, medical records, legal documents, and third-party liability statements.
- Subrogation Process Management
- Initiate and manage subrogation claims, including correspondence with third-party insurers, attorneys, and other involved parties.
- Ensure timely filing of subrogation demands and legal notices within applicable statutes of limitations.
- Recovery and Negotiation
- Negotiate settlements with third-party carriers or attorneys to recover the maximum amount for the health insurance plan.
- Work with internal and external legal counsel to pursue litigation when necessary.
- Documentation and Reporting
- Maintain accurate records of subrogation cases, including investigation findings, correspondence, and recovery outcomes.
- Prepare and submit detailed reports on subrogation activities and financial recoveries to management.
- Compliance and Collaboration
- Ensure compliance with applicable laws, regulations, and contractual agreements, including ERISA and state insurance statutes.
- Collaborate with claims adjusters, underwriters, and other internal teams to streamline subrogation efforts.
Qualifications
Education and Experience :
Skills and Competencies :
Key Competencies