Subrogation Specialist

SGS_JOB_3535

Business Support
Remote
Word
Excel
HIPAA

Contract - 6+ months contract

Location: REMOTE – Albany, NY We are seeking a Subrogation Specialist responsible for processing all casualty or estate functions involving multiple state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes intake, maintenance, claims review and selection, case management, settlement negotiations, and all related recovery functions. The role requires strong analytical skills, attention to detail, confidentiality, and the ability to manage high-volume case workloads while meeting internal and legal deadlines.

Job Responsibilities:

  • Ensure all processes meet HIPAA and Government security requirements regarding sharing, storage, and PHI (Personal Health Information).
  • Manage 700–1,000 subrogation cases at a time, including case notation and settlement negotiation.
  • Interact professionally with attorneys, insurance adjusters, medical providers, court staff, beneficiaries, family members, and clients through incoming and outgoing calls.
  • Prepare required correspondence, liens, claims, and related legal documents to advance case recovery.
  • Meet departmental standards for customer service, settlement goals, and file handling guidelines.
  • Perform document review, legal research, and case management to ensure proper workflow progression.
  • Confirm beneficiary eligibility documentation.
  • Conduct case document review and updates as necessary.
  • Validate third-party liability, probate matters, and beneficiary asset research.
  • Analyze and compile case data from multiple sources to determine case status and conclusions.
  • Process claim and lien disputes in coordination with attorneys and stakeholders.
  • Conduct periodic follow-ups on case status and recovery payments.
  • Negotiate and compromise claim/lien settlements per contract guidelines.
  • Sign and file notarized documents with counties for applicable cases.
  • Prioritize revenue-impacting case events and meet internal and legal deadlines.
  • Meet file handling and phone performance metrics.

Skills:

  • Subrogation
  • Medicaid and/or Medicare knowledge
  • Legal or Paralegal
  • Proficiency in Microsoft Office (Word & Excel)
  • Claim/ Claims
  • Excellent communication and legal case documentation skills

Education/Experience:

  • High School Diploma or equivalent required
  • Associate’s or Bachelor’s degree in Business, Legal Studies, Healthcare Administration, or related field preferred

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