Subrogation Specialist-Workers Compensation

Workers Compensation -Subrogation Specialist
Reports to: Claims Supervisor
Department: Subrogation
Status: Exempt
Position Summary: Responsible for the complete subrogation process of investigation, negotiation and settlement of workers’ compensation claims that have been identified to have subrogation potential.
Technical/Functional Responsibilities:
 Subrogation Process - Navigates through our proprietary database system and electronic documents to process and resolve claims with subrogation potential. Places adverse carriers on notice of our intent to subrogate. Negotiates settlements when possible or may negotiate liability based on a percentage when necessary or when liability is questionable. Evaluates the claim to decide if it should be referred to arbitration, suit or collections. Prepares any such claims for inter-company proceedings or legal forwarding. Recommends the closure of claims with no such potential.
 Subrogation Knowledge - Ability through experience and education to appropriately handle workers’ compensation subrogation files of moderate to high complexity. Demonstrates a thorough knowledge of all types of Workers’ Compensation subrogation claims. Has awareness of laws that govern insurance claims by keeping current on critical case laws, statutes and trends in the field of subrogation. Manages the application of that knowledge to maximize recovery efforts. Maintains certifications and licensures where applicable.
 Documentation - Prioritize and appropriately document all activities for recovery. Document files to include all conversations with all parties related to the claim, in-coming and out-going correspondence, current file updates, subrogation analysis, file resolution recommendations, applicable state negligence laws and statutes. Maintain diaries to be current, within 5 days, and sets timely and specific diaries on issues of subrogation for follow-up and correspondence.
 Customer Service and Communication Skills - Requires accomplished communication skills with a strong phone presence in extensive communication with insurance company clients, attorneys, law enforcement agencies and insureds. Must be able to handle difficult conversations and exhibit conflict management skills. All communication must maintain a reputation of professionalism, courtesy and respect. Assists internal and external customers with the resolution of moderately complex questions with little or no assistance from management.
 Team focused and goal oriented - Ability to work within a team environment in a positive and cooperative manner. Must be production and results oriented and consistently perform at or above given goals to include recovery, file quality and resolution timeliness.
Behavioral Competencies:
 Strong work ethic - Take ownership of tasks and see them through to completion. Honor commitments and fulfill promises. Be diligent and persistent to overcome difficult situations. Disciplined to focus on goals with a commitment to the outcome. The ability to make value-based decisions.
 Attention to Detail - Responsible for the accuracy and clarity of all documents. Ability to be thorough and complete when working, processing, or providing information and documentation: tracking details and creating accurate documentation even under pressure.
 Computer Proficiency – Ability to work in multiple computer systems efficiently and understand basic computer programs such as Outlook, Word and Excel.
 Teamwork – Consistently work in a positive and cooperative manner with fellow Team Members.
Educational Requirements:
 High School Diploma, College Degree or Certified Subrogation Recovery Professional, (CSRP) Designation
Experience Required:
 Five years or more of workers’ compensation claims and subrogation with inter-company arbitration filings experience.
Basic Requirements:
 Typing 45+ wpm accurately
 Computer application knowledge
 Claims system knowledge helpful
 Familiar with medical terminology and medical management processes, as well as practices in occupational safety and confidential records management.
 Basic accounting knowledge in order to make accurate computations
 Must be able to read, write and clearly speak English language
 Ability to travel to claim sites if needed