Case Coordinator, Subrogation

Overview

This role develops subrogation cases following the initial investigation to confirm viability. You will coordinate claim payment activity among health plans, collect refunds of duplicate payments from providers, and support successful recovery of 1st party funds. The position includes making final determinations on potential recovery sources and preparing cases for Paralegals to negotiate liability claims.

Strong phone presence is required, along with comfort interacting with insurance companies, providers, health plan members, and personal injury attorneys. Due to exposure of PHI sensitive data, this is considered a High Risk Role.

Responsibilities

• Review, identify, and develop subrogation opportunities by gathering missing information and potential sources of recovery.
• Conduct ongoing investigation, researching and analyzing gathered information.
• Maintain detailed, accurate records throughout the lifecycle of each case.
• Validate claim viability and terminate pursuit when necessary.
• Respond timely to electronic, written, and verbal communications.
• Place parties of interest on notice and send subsequent demand letters.
• Perform continuous outbound calls to request case information or status to drive cases toward settlement readiness.
• Maintain detailed case records and calendar diaries to track case activities and meet department expectations.
• Proactively resolve and/or transfer cases by engaging Negotiators/Paralegals as needed.
• Ensure compliance with state and federal laws, and maintain departmental productivity and quality standards.
• Handle transferred calls and/or documents from inbound investigation teams to provide resolution.
• Collaborate, coordinate, and communicate across disciplines and departments.
• Ensure compliance with HIPAA regulations and requirements.

Job Scope

• Operate independently under limited supervision.
• Make decisions within specified parameters and obtain advice/help from a legal manager, negotiator, or paralegal to proactively resolve cases.
• Work across customers, beneficiaries, providers, and supplemental payors while maintaining positive relationships.
• Prioritize external and internal customer needs when making decisions and taking action.

Requirements

• Minimum high school diploma plus two (2) years of subrogation, collections, insurance, or coordination of benefits (COB) experience.
• Bachelor’s degree in a relevant field is preferred.
• Working knowledge of Microsoft Office and internet research skills.
• Excellent verbal and written communication skills.
• Strong organizational and time management skills, with the ability to multi-task and work independently.
• Strong analytical, problem-solving, and decision-making skills; ability to exercise good judgment.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Required licensures, professional certifications, and/or Board certifications as applicable.
• Ability to work in a standard office environment requiring sitting and viewing monitor(s) for extended periods of time and operating standard office equipment (including keyboard, copier, and telephone).

Compensation & Benefits

• Salary range: 41K–55K
• Specific offers take into account a candidate’s education, experience, and skills, as well as work location and internal equity.
• Eligible for health insurance, 401k, and bonus opportunity.

Preferred Qualifications

• Bachelor’s degree in a relevant field

Location

Standard office environment (role requires sitting and viewing monitor(s) for extended periods of time).