Job Details

Subrogation Professional II

Company name
Humana Inc.

Location
Portland, ME, United States

Employment Type
Full-Time

Industry
Bilingual

Posted on
Apr 28, 2023

Apply for this job






Profile

Description

The Subrogation Professional II identifies, investigates, and collects recoveries from third parties who are legally responsible for paying all or part of medical expenditures for an organization that provides health insurance. The Subrogation Professional II work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

Responsibilities

The Subrogation Professional II interacts with attorneys and third-party insurance professionals to explore where there may be liability and negotiate and coordinate claim payments. Ensure Coordination of Benefits (COB) records for members who have other insurance coverage are up-to-date. Respond to subrogation inquiries regarding third-party liability policies and procedures. Career-Development position within field. Conducts tasks and assignments as directed. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Required Qualifications

Minimum 3 years of subrogation experience in healthcare and/or property, casualty, or worker's compensation

Strong Microsoft Office proficiency - ability to create forms, reports, and documents in Word, Excel, and/or Power BI

Strong written and verbal communication skills

Highly analytical and tech-savvy

Strong organizational abilities

Ability to manage multiple time sensitive tasks

Excellent ability to interact with associates at all levels of the organization

This is a remote position that will require travel of less than 5%

Work-At-Home Requirements

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested

Satellite, cellular and microwave connection can be used only if approved by leadership

Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.

Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Preferred Qualifications

Undergraduate degree

Knowledge of Microsoft Access

Bilingual in English and Spanish- written and verbal

Covid-19 Vaccine Policy

Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Every associate and contractor who work inside a Humana facility or in the field, regardless of vaccination status, must complete a daily health screening questionnaire.

Additional Information

As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn't missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews #LI-Remote

Scheduled Weekly Hours

40

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Company info

Humana Inc.
Website : http://www.humana.com

Similar Jobs:
Pre-Authorization Nursing Supervisor
Location : Portland, ME
Description The Supervisor, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakehol...
Description The Bilingual Manager, Learning Facilitation , plans, coordinates, and implements all aspects of training programs for participants throughout for Grievance and Appeals / Careplus. EST states Responsibilities The B...
Bilingual Quality Auditor
Location : Portland, ME
Job Information Humana Bilingual Quality Auditor in Portland Maine Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. Revi...
What I liked about the service is that it had such a comprehensive collection of jobs! I was using a number of sites previously and this took up so much time, but in joining EmploymentCrossing, I was able to stop going from site to site and was able to find everything I needed on EmploymentCrossing.
John Elstner - Baltimore, MD
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
BilingualCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
BilingualCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2024 BilingualCrossing - All rights reserved. 169 192