Other Party Liability - Subrogation Coordinator
Cambia Health

Job Info

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Other Party Liability - Subrogation Coordinator

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.
  
• Strong oral, written and interpersonal communication skills
  
• 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
  

The expected hiring range for an Other Party Liability - Subrogation Coordinator is $55,000- $70,000 depending on skills, experience, education, and training; relevant licensure / certifications; performance history; and work location. The bonus target for this position is 5%. The current full salary range for this role is $52,000 - $84,500.

Base pay is just part of the compensation package at Cambia that is supplemented with an exceptional 401(k) match, bonus opportunity and other benefits. In keeping with our Cause and vision, we offer comprehensive well-being programs and benefits, which we periodically update to stay current. Some highlights:

• medical, dental, and vision coverage for employees and their eligible family members
  
• annual employer contribution to a health savings account ($1,200 or $2,500 depending on medical coverage, prorated based on hire date)
  
• paid time off varying by role and tenure in addition to 10 company holidays
  
• up to a 6% company match on employee 401k contributions, with a potential discretionary contribution based on company performance (no vesting period)
  
• up to 12 weeks of paid parental time off (eligible day one of employment if within first 12 months following birth or adoption)
  
• one-time furniture and equipment allowance for employees working from home
  
• up to $225 in Amazon gift cards for participating in various well-being activities. for a complete list see our External Total Rewards page.
  

We are an Equal Opportunity and Affirmative Action employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A background check is required.

If you need accommodation for any part of the application process because of a medical condition or disability, please email CambiaCareers@cambiahealth.com. Information about how Cambia Health Solutions collects, uses, and discloses information is available in our Privacy Policy. As a health care company, we are committed to the health of our communities and employees during the COVID-19 pandemic. Please review the policy on our Careers site.

This job has expired.