What are the responsibilities and job description for the Subrogation Specialist position at DELTA HEALTH SYSTEMS MCC?
Job Details
Job Location: Stockton, CA
Position Type: Full Time
Salary Range: $25.00 - $30.00 Hourly
Job Category: Other
Description
Job Summary:
The Subrogation Specialist is responsible for investigating, managing, and resolving subrogation claims on behalf of our self-funded clients. This position involves detailed analysis, negotiation with parties involved, and communication with legal and claims teams to pursue the recovery of financial losses.
Key Responsibilities:
- Claim Investigation:
- Review third party liability letters, police reports, etc. to determine if subrogation is applicable.
- Investigate the circumstances of the loss, identify potential third parties, and gather evidence to support the subrogation claim.
- Review policy terms, conditions, and exclusions to assess liability and recovery options.
- Communication & Negotiation:
- Liaise with claimants, legal teams, third parties, and vendor partners.
- Negotiate settlements and monitor recovery efforts until the claim is resolved.
- Documentation & Reporting:
- Maintain accurate and detailed records of all subrogation efforts, including communications, negotiations, and settlement agreements.
- Prepare and submit detailed reports on claim status and recovery efforts to management.
- Maintain and update stoploss working documents, as well as policies and procedures.
- Compliance & Legal Coordination:
- Ensure all subrogation activities comply with legal and regulatory requirements.
- Work closely with internal legal teams to pursue litigation if necessary, including providing case details and assisting with legal proceedings.
- Collaboration:
- Work with vendor partners and internal teams to ensure effective coordination of subrogation efforts.
- Identify trends in subrogation claims and provide recommendations for process improvements.
Qualifications
Required Skills & Qualifications:
- Education:
- A high school diploma or equivalent is required. A bachelor's degree in business, insurance, or a related field is preferred.
- Experience:
- Minimum of 2-3 years of experience in insurance claims, subrogation, or a related field.
- Experience with subrogation claims handling, legal processes, and recovery strategies is highly preferred.
- Skills:
- Strong analytical and investigative skills.
- Excellent written and verbal communication skills.
- Third Party Liability & Worker’s Compensation knowledge helpful.
- Attention to detail and ability to manage multiple cases simultaneously.
- Knowledge of insurance policies, subrogation laws, and industry regulations.
- Technical Proficiency:
- Proficiency in using claims management software and Microsoft Office Suite (Excel, Word, etc.).
Preferred Qualifications:
- Certifications:
- Certification as a Subrogation Specialist (e.g., Certified Subrogation Recovery Specialist, CSRS) is a plus.
- Experience:
- Prior experience working in a legal or insurance setting, particularly with subrogation recovery efforts
Salary : $25 - $30