Washington, DC, United States
Nov 11, 2021
The Subrogation Representative 3 identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health insurance. The Subrogation Representative 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.
The Subrogation Representative 3 interacts with attorneys and third-party insurance professionals to explore where there may be liability and negotiate and coordinate claim payments. Ensure Coordination of Benefits (COB) records for members who have other insurance coverage are up-to-date. Respond to subrogation inquiries regarding third-party liability policies and procedures. Career-Development position within field. Conducts tasks and assignments as directed. Decisions are typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and works under limited guidance due to previous experience/breadth and depth of knowledge of administrative processes and organizational knowledge.
1 year experience in a call center and/or production environment.
Strong Microsoft Office Proficiency - ability to create forms, reports, and documents in Word and Excel
Capacity to maintain confidentiality
Ability to manage multiple time sensitive tasks
Strong written and verbal communication skills
Strong organizational abilities
Strong typing and computer navigation skills, including use of multiple computer applications simultaneously
High School Diploma or equivalent
Associate or Bachelor's Degree
Subrogation or health insurance knowledge
Fully Bilingual/English/Spanish - able to speak, read and write in both languages without limitations or assistance.
Claims Processing Experience
Work at Home/Remote Requirements
Must ensure designated work area is free from distractions during work hours and virtual meetings
Must provide a high-speed DSL or cable modem for a workspace (Satellite and Hotspots are prohibited). A minimum standard speed of 10x1 (10mbs download x 1mbs upload) for optimal performance of is required
Scheduled Weekly Hours