Payment Integrity Subrogation Specialist

Job Summary
The Subrogation Specialist investigates claims involving potential third-party liability and pursues reimbursement on behalf of employer-sponsored health plans. This role supports financial recovery, reduces plan costs, and ensures compliance with contractual and regulatory requirements.

Key Responsibilities

Subrogation Operations

• Identify claims involving potential third-party liability
• Investigate accident details and insurance coverage
• Initiate subrogation recovery activities
• Prepare lien calculations and reimbursement documentation

Financial Recovery and Risk Management

• Pursue reimbursement from responsible parties
• Track recovery amounts and case outcomes
• Ensure accurate financial reporting

Compliance and Documentation

• Maintain detailed documentation of subrogation cases
• Ensure adherence to regulatory and contractual requirements
• Support audit and compliance activities

Continuous Improvement

• Identify opportunities to improve recovery processes

Skills experience required:

• High School diploma or equivalent
• 2+ years or more of experience in subrogation, claims, or healthcare billing

Desired Skills

• Experience in healthcare claims or Third-Party Administrator environments
• Familiarity with subrogation laws and ERISA requirements

Pay: $21.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid sick time
• Paid time off
• Vision insurance

Work Location: In person