Subrogation Specialist - Healthcare

Title: Subrogation Specialist (Healthcare)

Location: United States

• Job Identification14775
• Job RoleSubrogation-Subrogation
• Experience (In Years)0-3
• Job LocationRemote

Job Description:

This is a Remote Full-time opportunity

This position requires the Subrogation Specialist to process a paperless health insurance subrogation caseload by investigating potential cases and pursuing med-pay, no-fault, liability, and workers' compensation recoveries.

Responsibilities include, investigating new potentials cases, placing outbound calls as well as submitting correspondence to health plan members, insurance companies, and attorney offices. The Subrogation Specialist coordinates efforts with other members of the subrogation team to maximize recovery in accordance with EXL's Subrogation Policies and Procedures.

Complying with HIPAA regulations as well as EXL's HIPAA and Information Security policies and procedures, including required training and incident reporting.

EXL (NASDAQ: EXLS) is a leading data analytics and digital operations and solutions company. We partner with clients using a data and AI-led approach to reinvent business models, drive better business outcomes and unlock growth with speed. EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL was founded in 1999 with the core values of innovation, collaboration, excellence, integrity and respect. We are headquartered in New York and have more than 54,000 employees spanning six continents. For more information, visit www.exlservice.com.

EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates. EXL will only extend a job offer after a candidate has gone through a formal interview process with members of EXL's Human Resources team, as well as our hiring managers.

Required Skills

• Working knowledge of Microsoft Word, Excel, internet research skills
• High School or equivalent education level

Preferred Requirements

• 1+ years of subrogation experience
• 1+ years of claims experience.
• 1+ years of heavy call volume support experience

Professional Skills

• Developed customer service skills.
• Strong organizational and time management skills
• Ability to work independently and as part of a team.

Compensation - $16.00 - $19.00 hourly (DOQ)*

What We Offer

EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.

From your very first day, you get an opportunity to work closely with highly experienced, world-class Healthcare consultants.

You can expect to learn about many aspects of businesses that our clients engage in. You will also learn effective teamwork and time management skills - key aspects for personal and professional growth.

We provide guidance/ coaching to every employee through our mentoring program where in every junior level employee is assigned a senior level professional as advisors.

Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.

• The posted range is the hiring range for this role - a subset of the broader range available to employees over time - and reflects base salary across our national hiring scale. Final offers are based on several factors, including the candidate''s skills and experience, internal pay equity, work location, market conditions for the role, and the specific scope and responsibilities of the position. The top of the range is reserved for candidates who notably exceed the requirements; the lower end applies to those with less experience or fewer preferred qualifications. For positions based in higher-cost zones (e.g., California, New York, New Jersey), actual compensation may exceed the posted range; your recruiter will share specifics during the process.
• Learn and understand fundamentals of health insurance subrogation, including basic health plan contractual provisions that apply to the reimbursement efforts.
• Review, Identify and develop subrogation opportunities by gathering missing information and potential sources of recovery.
• Place parties of interest on notice
• Organize and structure investigations to work in priority order using the tools provided.
• Respond timely to all electronic, written, and verbal communications.
• Log and maintain detailed and accurate records.
• Access and pull benefits from clients' health claim systems.
• Pursue worker's compensation, third party liability, first party uninsured and underinsured recovery, worker's compensation, med-pay coverage, and no-fault recoveries.
• Engage advice and/or help of legal manager to proactively resolve cases.
• Ensure compliance of state and federal laws
• Adhere to settlement authority levels.
• Maintain department productivity and quality standards.
• Sensitivity to privacy in accordance with HIPAA guidelines
• Learn and understand fundamentals of health insurance subrogation, including basic health plan contractual provisions that apply to the reimbursement efforts.
• Review, Identify and develop subrogation opportunities by gathering missing information and potential sources of recovery.
• Place parties of interest on notice
• Organize and structure investigations to work in priority order using the tools provided.
• Respond timely to all electronic, written, and verbal communications.
• Log and maintain detailed and accurate records.
• Access and pull benefits from clients' health claim systems.
• Pursue worker's compensation, third party liability, first party uninsured and underinsured recovery, worker's compensation, med-pay coverage, and no-fault recoveries.
• Engage advice and/or help of legal manager to proactively resolve cases.
• Ensure compliance of state and federal laws
• Adhere to settlement authority levels.
• Maintain department productivity and quality standards.
• Sensitivity to privacy in accordance with HIPAA guidelines