Subrogation Specialist, Sr. jobs in California

Subrogation Specialist, Sr. is responsible for subrogation activities including the identification and research of subrogation claims. Assists in the recovery of overpayments. Being a Subrogation Specialist, Sr. coordinates with other departments, insurance representatives and members. Processes subrogation, workers' compensation, and other claims where third-party liability exists. Additionally, Subrogation Specialist, Sr. develops cases resulting from beneficiary or provider-initiated inquiries, internal referrals, personal research, or computer-generated reports. Requires a high school diploma. Typically reports to a supervisor. The Subrogation Specialist, Sr. works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Subrogation Specialist, Sr. typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)

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Subrogation Specialist
  • Customized Services Administrators, Inc.
  • San Diego, CA FULL_TIME
  • Why work with us?

    The North American branch of Generali Global Assistance offers a diverse and inclusive work environment while employees work towards making real difference in the lives of our clients. As an Organization, we pride ourselves with offering white glove service while being mindful of corporate responsibility and our environmental footprint.

    Employees enjoy a plethora of benefits to include:

    • A diverse, inclusive, professional work environment
    • Flexible work schedules
    • Company match on 401(k)
    • Competitive Paid Time Off policy
    • Generous Employer contribution for health, dental and vision insurance
    • Company paid short term and long term disability insurance
    • Paid Maternity and Paternity Leave
    • Tuition reimbursement
    • Company paid life insurance
    • Employee Assistance program
    • Wellness programs
    • Fun employee and company events
    • Discounts on travel insurance

    Who are we?

    Generali Global Assistance is proudly part of the Europ Assistance Group brand and our products utilize a number of corporate and product brands. The brands for our North American team include the following:

    • CSA: US travel insurance brand for retail and lodging partners. Learn more here.
    • Generali Global Assistance (GGA): The primary Corporate brand in the United States for our travel insurance, travel assistance, identity and cyber protection, and beneficiary companion products. Learn more here.
    • GMMI: the industry standard for global medical cost containment and medical risk management solutions. Learn more here.
    • Iris, Powered by Generali: identity and digital protection solution. Learn more here.
    • Trip Mate: US travel insurance brand for tour operator, cruise and airline partners. Learn more here.

    What you’ll be doing.

    Job Summary:

    • Support Claims Teams in North America in becoming Claims Subrogation best-in-class.
    • Define a clear strategy and the key priorities for the Subrogation program.
    • Be accountable for the Subrogation targets achievement.
    • Manage directly the most complex and high value subrogation cases.
    • Support building and guarantee the right execution of the various action plans in close collaboration with the different involved Claims Teams.
    • Design claims processes adaptation for maximizing our Subrogation opportunities in close collaboration with the Claims Team.
    • Design automatic rules for Subrogation detection and guarantee their right and consistent implementation.
    • Collaborate with UDW Team enabling to reinforce our Subrogation opportunities (e.g. co-insurance rules) in the T&Cs building / improvements.

    Principal Duties and Responsibilities:

    Monitor the Subrogation KPIs and be accountable for target achievement.

    • Define, on a collaboration mode, yearly Subrogation targets with each claims department.
    • Consolidate on a regular basis a Subrogation Dashboard embedding savings but also operational KPIs split per department, Business Partners, type of claims…
    • Set up an adequate governance framework to review results, main cases, trends with the respective claims teams.
    • Ensure timely and accurate Subrogation reporting for compliance and regulation purposes.

    Reinforcing detection subrogation skills of the Claims Teams

    • Build and monitor dedicated action plans for each claim department.
    • In close collaboration with Claims Teams, design and deploy Claims processes adjustments, in particular, at First Notification of Loss (FNOL) stage and allowing a:
      • more systematic subrogation detection opportunity,
      • an accurate Liability assessment.
    • Design and deploy specific and adapted e-Learning modules for claims teams (jointly with the training department).
    • Build and maintain a Subrogation Guideline including a clear and comprehensive articulation between the claims process and the full cycle time of a Subrogation case.

    Reinforce our IT capabilities in close collaboration with Claims Teams

    • Design automatic alerts for reinforcing Subrogation detection in the various Claims IT systems and guarantee their right and consistent implementation.
    • Design / select a workflow capability for allowing an efficient monitoring of the Subrogation cases and guarantee its right and consistent implementation.

    Monitor carefully the most complex and high value subrogation cases.

    Drive the performance of external Subrogation services providers.

    • Define a clear externalization strategy: types of Subrogation cases to be managed externally /internally.
    • Manage the contractual relationship.
    • Define clear KPIs and a clear Governance framework for driving the providers performance.

    Leadership

    • Act as a Subrogation expert within the company, supporting peers to continuously improve maturity level.
    • Act as point of contact for Europ Assistance Group Subrogation topics.

    Other responsibilities as assigned by Senior Director, Claims Technical Excellence.

    Required / Desired Knowledge, Experiences and Skills:

    • Minimum of 8 years of prior knowledge and experience in healthcare and/or insurance field for processing claims and or subrogation management.
    • Strong analytical skills required including demonstrated ability to analyze raw data, draw conclusions, and develop actionable recommendations.
    • Knowledge of developing standards, procedures, guidelines etc.
    • A minimum of 3 years’ experience in a management or supervisory role is preferred.
    • Must be able to represent the organization in a professional and knowledgeable manner.
    • Excellent verbal and written communication skills with ability to manage and prioritize multiple tasks.
    • Computer skills necessary to work effectively: Windows Microsoft Word, Excel, and Power Point Proven ability to work under pressure, prioritize work and meet multiple deadlines.
    • Excellent interpersonal and relationship building skills with a proven track record of leadership across functional lines that delivers business results.
    • Experience or demonstrated knowledge of travel insurance, travel assistance or health care/insurance preferred.
    • Excellent problem-solving skills and capability to troubleshoot the most difficult claim issues.

    Education/Certifications:

    Requirements:

    • High School Diploma or Equivalent (GED) required.

    Preferred:

    • Associate’s degree or equivalent

    Pay Range: $85-100k

    Where you’ll be doing it.

    This is a hybrid role based out of our San Diego, CA or Pembroke Pines, FL office. As a hybrid role, you will be working onsite 2-3 days a week and working from home 2-3 days a week.

    When you’ll be doing it.

    While there is some flexibility in the hours, this position will be Monday-Friday during regular business hours (approximately 8:00am-5:00pm). Occasional overtime may be required according to business need.

    Apply today to begin your next chapter.

    Don’t meet every single requirement? At Generali Global Assistance, we are dedicated to building a diverse, inclusive and enriching workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyways. You may be just the right candidate for this or other roles.

    California Residents - Privacy Notice for California Residents Seeking Employment with Generali Global Assistance is available here: https://us.generaliglobalassistance.com/privacy-notice-for-california-residents-seeking-employment/

    The Company is committed to providing equal employment opportunity in all our employment programs and decisions. Discrimination in employment on the basis of any classification protected under federal, state, or local law is a violation of our policy. Equal employment opportunity is provided to all employees and applicants for employment without regard age, race, color, religion, creed, sex, gender identity, gender expression, transgender status, pregnancy, childbirth, medical conditions related to pregnancy or childbirth, sexual orientation, national origin, ancestry, ethnicity, citizenship, genetic information, marital status, military status, HIV/AIDS status, mental or physical disability, use of a guide or support animal because of blindness, deafness, or physical handicap, or any other legally protected basis under applicable federal, state, or local law. This policy applies to all terms and conditions of employment, including, but not limited to, recruitment and hiring, classification, placement, promotion, termination, reductions in force, recall, transfer, leaves of absences, compensation, and training. Any employees with questions or concerns about equal employment opportunities in the workplace are encouraged to bring these issues to the attention of Human Resources. The Company will not allow any form of retaliation against individuals who raise issues of equal employment opportunity. All Company employees are responsible for complying with the Company’s Equal Opportunity Policy. Every employee is to treat all other employees equally and fairly. Violations of this policy may subject an employee to disciplinary action, up to and including termination of employment.

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Subrogation Program Specialist
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  • San Diego, CA FULL_TIME
  • Why work with us? The North American branch of Generali Global Assistance offers a diverse and inclusive work environment while employees work towards making real difference in the lives of our client...
  • 26 Days Ago

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Attorney - Subrogation
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Subrogation Collection Manager
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  • Campbell, CA FULL_TIME
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Central Subrogation Claims Supervisor
  • Procom
  • California, CA FULL_TIME
  • As a Central Subrogation Claims Supervisor, you will be responsible for managing a team of Subrogation Examiners. This role involves closely monitoring the subrogation claims inventory of your assigne...
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Sr. Subrogation Specialist
  • Connecticut Interlocal Risk Management Agency (cirma)
  • New Haven, CT
  • Connecticut Interlocal Risk Management Agency (CIRMA) Sr. Subrogation Specialist SR. SUBROGATION SPECIALIST Is your ordi...
  • 4/25/2024 12:00:00 AM

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Subrogation Specialist
  • Calculated Hire
  • Indianapolis, IN
  • Subrogation Specialist Remote - Pittsburgh, Columbus, Indy Full-Time $52k+/year Our client is seeking qualified Subrogat...
  • 4/24/2024 12:00:00 AM

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Subrogation Specialist
  • Calculated Hire
  • Pittsburgh, PA
  • Subrogation Specialist Remote - Pittsburgh, Columbus, Indy Full-Time $52k+/year Our client is seeking qualified Subrogat...
  • 4/24/2024 12:00:00 AM

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Claims Specialist
  • Calculated Hire
  • Detroit, MI
  • Subrogation Specialist Hybrid/Remote Depending on Location Full-Time $52k+/year Our client is seeking qualified Subrogat...
  • 4/24/2024 12:00:00 AM

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Subrogation Specialist
  • Calculated Hire
  • Hudson, OH
  • Subrogation Specialist Hudson, OH - Hybrid Full-Time $52k+/year Our client is seeking qualified Subrogation Specialists ...
  • 4/23/2024 12:00:00 AM

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Sr. Subrogation Specialist
  • Connecticut Interlocal Risk Management Agency (CIRMA)
  • New Haven, CT
  • Connecticut Interlocal Risk Management Agency (CIRMA) Sr. Subrogation Specialist SR. SUBROGATION SPECIALIST Is your ordi...
  • 4/22/2024 12:00:00 AM

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Claims Specialist
  • Calculated Hire
  • Cleveland, OH
  • Subrogation Specialist Direct Hire/Full-time Hudson, OH - Onsite $52K+ Our client is seeking qualified Subrogation Speci...
  • 4/22/2024 12:00:00 AM

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Medical Subrogation Specialist
  • Smith Clinesmith
  • Dallas, TX
  • Description We are seeking a highly skilled and experienced Lien Specialist to join our team. As a Lien Specialist, you ...
  • 4/21/2024 12:00:00 AM

California is a state in the Pacific Region of the United States. With 39.6 million residents, California is the most populous U.S. state and the third-largest by area. The state capital is Sacramento. The Greater Los Angeles Area and the San Francisco Bay Area are the nation's second and fifth most populous urban regions, with 18.7 million and 9.7 million residents respectively. Los Angeles is California's most populous city, and the country's second most populous, after New York City. California also has the nation's most populous county, Los Angeles County, and its largest county by area, S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Subrogation Specialist, Sr. jobs
$58,873 to $74,438