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 III interacts with attorneys and third-party insurance professionals to explore where there may be liability and negotiate and coordinate claim payments. The Subrogation Representative III 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. This individual ensures Coordination of Benefits (COB) records for members who have other insurance coverage are up to date. This individual responds to subrogation inquiries regarding third-party liability policies and procedures. The Subrogation Representative III conducts tasks and assignments as directed and understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. This individual makes decisions regarding their own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. This individual follows established guidelines/procedures.
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Required Qualifications
- Minimum 1 year of experience in healthcare and/or subrogation experience in the property, casualty, or worker’s compensation fields
- Minimum 2 years of experience in a call center and/or production environment
- Strong Microsoft Office Proficiency – ability to create forms, reports, and documents in Word and Excel
- Strong typing and computer navigation skills, including use of multiple computer applications simultaneously
- Capacity to maintain confidentiality
- Ability to manage multiple time sensitive tasks
- Strong written and verbal communication skills
- Strong organizational abilities
Work-At-Home Requirements
- At minimum, a download speed of 25 mbps and an upload speed of 10 mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Preferred Qualifications
- Undergraduate Degree
- Bilingual in English/Spanish
- Claims Processing Experience
Additional Information
- As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called HireVue. HireVue Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.
- If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours
40Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us
Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
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