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Subrogation Specialist Resume Samples
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6-10 years of experience
- Recovered revenue spent on behalf of policyholders through negotiation, arbitration, mediation or litigation
- Reached subrogation goal by recovering $1.5M in one year
- Broke a company wide record by recovering over $200,000 in one month
- Developed and implemented procedures to increase recovery revenue
- Trained and supervised entry level subrogation specialists
0-5 years of experience
- Analyzed each potential financial recovery opportunity to determine, with full authority, which to pursue on behalf of health insurer resulting in over $200M in departmental recoveries. Managed complex caseload currently in excess of $5M, researching each case and claims thoroughly to ensure maximum recoveries
- Developed training processes and procedures for both individuals and groups on internal computer systems, mainframes, job duties and pertinent laws and regulations
- Executed supplementary ad hoc projects, such as analyzing Excel spreadsheets, UAT testing and processing new client materials, while achieving above standard job performance metrics of 98% quality and 25% aging inventory
- Earned 4th Quarter 2014 bonus for facilitating implementation of new computer system
0-5 years of experience
Recovered funds related to UTi cargo claims (Globally) from contracted carriers that had a direct financial impact on UTi.
- Responsible for subrogation activities including the identification and research of subrogation claims.
- Processed cargo claims within the UTi Risk Console System.
- Supported UTi customers (internal and external) in a professional, accurate, and timely manner.
- Designed and delivered presentations as required. Reviewed, evaluated, interpreted, and presented data as needed.
- Reviewed claim files to evaluate recovery potential.
- Negotiated with insurance companies and attorneys to maximize the subrogation recovery and reach agreement on settlements; evaluate facts and evidence, liability, and amount of damages.
- Ensured claim procedures are updated, provide Microsoft Visio workflows.
10+ years of experience
With respect to subrogation recovery efforts, create expectations for the zone in cooperation with the needs of the zone and the recovery departments; oversees standards for handling of subrogation claims and referrals, analyze current status of the claim to recommend action to minimize leakage, identify SDIP coding errors and drive the overall recovery results.
- Responsible for consulting on open files and auditing closed files, along with identifying any missed subrogation opportunities to drive recovery results.
- Travels 2-4 times per month to the Sacramento Office for training needs of the office for new or experienced
- Generate month end reports to capture recoveries of prior identified opportunities, current opportunities and YTD results.
- Complete any and all special projects assigned with accuracy and with deadline; these are typically assigned last minute and require analyzing and recommended correction plan; Subrogation audit rebuttals, SDIP audits, ACIC audit, Special reviews.
6-10 years of experience
- Evaluated and negotiated subrogation recoveries with third party carriers, responsible party(s) and other legal representatives/attorneys.
- Determined arbitration and litigation recovery potential prior to filing suit.
- Collaborated with Claims Representatives to ensure all evidence received and investigations complete. Settled cases within given authority level.
- Identified carriers of responsible party/parties. Determined extent of liability, damages and contribution potential.
- Managed the pursuit and recovery of subrogation claims in a timely and aggressive manner.
0-5 years of experience
- Directed the liability investigations from a recovery perspective involving personal homeowner claims
- Evaluated legal liability and aggressively pursued, negotiated and resolved subrogation claims.
- Secured additional information/investigation from claim offices when onsite investigation was necessary.
- Communicated with insured, witnesses, attorneys and underwriters to obtain/provide necessary information.
- Responsible for litigation management.
0-5 years of experience
- In 2016, recovered over $4 million, surpassing goal of $2.4 million
- Achieved highest dollar recovery amount for my unit (over $595,000)
- Worked Michigan Catastrophic Claims Association (MCCA) PIP files
- Exceeded the established closing ratio (closed to open files) per month at 118%
- Worked on and maintain 400-500+ files, following up on each to bring them to conclusion
- Filed intercompany arbitration, placed files with outside counsel to achieve highest dollar amount in settling claims
- Participated in mediations via phone
- Trained new associates for subrogation/recovery tech
- Assisted in developing a new system called (IRIS) – originally created to be used in Ireland – for use in the United States
- Contributed to [company name]’s WOW program designed to motivate associates and improve productivity using employee feedback
0-5 years of experience
- Reviewed cases involving possible workers’ compensation or subrogation determining which cases to deny pay or investigate further for one of the company’s largest accounts.
- Interacted orally and in written form with attorneys, customers, providers, Workers’ Compensation Board and the company’s legal counsel to resolve cases.
- Provided information, research and relevant materials necessary for negotiations of settlement of a case. Maintained follow-up procedures with pending subrogation cases. Assisted in training other department personnel in subrogation and coordination of benefits.
- Made logical claims adjudication decisions and assigned diagnosis and procedure codes to claims.
6-10 years of experience
- Subrogated insurance companies, third parties, and uninsured’s for payment
- Processed collected payments, negotiated payments and filed arbitrations on disputed cases
- Effectively generated a large volume of complex letters
- Maintained high volume of paper files, hired vendors and attorneys to manage cases and suits
0-5 years of experience
- Analyzed contracts, leases, contracts, by-laws and investigated claim to determine liability and responsibility of claim participants.
- Distinguished recoverable property damages, and pursued reimbursement as a 3rd party administrator.
- Negotiated claims based on liability assessment, damages and mitigating/aggravating factors to facilitate settlement.
0-5 years of experience
- Responsible for establishing the Subrogation and Collection department.
- Facilitated training and managed all interaction in Subrogation and Collections department.
- Reviewed auto and homeowners claims referred to subrogation collection.
- Pursuing appropriate action to facilitate prompt collection and recovery.
- Total number of Clients 50, collected on all accounts 40 days past due.
0-5 years of experience
- Provide a persuasive written account of the loss to be presented to an arbitration panel to recover damages paid out on not at fault losses
- Quarterly performer for percentage collected
- Recognized and chosen to participate in Advanced Development Program (internal leadership development program)
- Responsible for onboarding of new hires and facilitating tours of the department for outside business groups
- Coordinate special events for work group (Military Appreciation Month, charitable events, year-end celebratory event)
6-10 years of experience
- Promoted to handle large work drive of subrogation accounts.
- Completed several classes and training sessions to become more knowledgeable in the insurance industry.
- Assisted in training new employees.
- Promoted to Specialist II due to consistent success in achieving monthly goals, proven liability analysis skills, and outstanding general knowledge of the subrogation process.
- Chosen to handle a work drive of several types of subrogation claims including: bodily injury, auto property damage, homeowner’s property damage, rental and commercial claims.
- Proven ability to be a top collector on uninsured motorist accounts.
6-10 years of experience
- Promoted to handle large work drive of subrogation accounts.
- Completed several classes and training sessions to become more knowledgeable in the insurance industry.
- Assisted in training new employees.
- Promoted to Specialist II due to consistent success in achieving monthly goals, proven liability analysis skills, and outstanding general knowledge of the subrogation process.
- Chosen to handle a work drive of several types of subrogation claims including: bodily injury, auto property damage, homeowner’s property damage, rental and commercial claims.
- Proven ability to be a top collector on uninsured motorist accounts.
0-5 years of experience
- Daily interaction with Insured’s, Collection vendors, Attorneys, Agents, And Adverse parties in an attempt to secure collection on open claims
- Maintain a case load of over 4,500 files
- Focus on Quality by achieving 100% monthly audits
- Proficient in all Microsoft programs, Lotus Notes, CRN, Heart, and Subro Source
- Maintain Production standards monthly
6-10 years of experience
Responsible in identifying and protecting legal subrogation rights and recovering funds from responsible parties.
- Determines in individual cases where possibilities for subrogation and recoveries exist.
- Applies rules and statutes to fact situations to identify possible resources on which to base a demand for reimbursement from third party payers.
- Uses available resources to investigate claim situations and identify other entities and individuals with resources against which subrogation or recovery claims can be made.
- Reviews and evaluates accident or incident reports, individual claims, medical or other documents relating to funds paid out by an agency.
- Notifies other parties and insurance carriers or attorneys of the agencys subrogation or recovery interest; confers with other parties, insurance carriers and attorneys concerning potential settlement or other actions
- Negotiate settlements of subrogation claims; makes recommendations to obtain final approval.
- Prepares and maintains case files, correspondence, legal documents and other information related to subrogation claims
0-5 years of experience
Responsible for recovery of subrogation files for auto and property claims
- Aggressively contacted adverse insurance carriers for payment of subrogation claims and negotiate liability
- Filed inter-company arbitration when liability disputes were unresolved.
- Contact uninsured motorists to establish monthly payment plan and/or cash settlement of debt.
- Monitor files to ensure timely payments are made. Follow up via telephone when payments were past due.
- Work with collection agencies and attorneys in pursuing uninsured motorists.
0-5 years of experience
- Responsible for investigating BMCHP members for other insurance coverage.
- Review and analyze data from systems reports to identify problems and resolve errors.
- Process Coordination of Benefits from Third Party Liability claims; complete weekly and monthly activity reports and communicate the Coordination of Benefits /Third Party Liability policies to internal and external sources.
- Responsible for the overall recovery efforts of the department.
- Protect BMC’s subrogation rights by filing statutory liens as well as negotiate with attorneys to protect BMC’s interests regarding lien settlements.
- Reviewed, evaluated adjudicated claims according to productivity and quality standards while demonstrating complicated judgment and decision making skills.
- Maintained knowledge of benefits, policies, and procedures, provider network development, contract issues, processing system issues, Massachusetts Medicaid regulations and compliance, and all industry standards for claims adjudication.
0-5 years of experience
- Claims triage and settlement for the USAA client team.
- Analyze insurance claims to determine third party liability and identify subrogation potential.
- Demonstrate ability to work with claims adjusters, lead investigators and other managers adhering to all project timelines while delivering profitable results for clients.
0-5 years of experience
- Determine liability with Auto, Property, MED/PIP, WC claims to determine if there is subrogation potential
- Oversee claims during entire subrogation life cycle
- Vendor management with multiple businesses
- Negotiate with other insurance companies to maximize recovery
- Review files to determine if they are litigation worthy
0-5 years of experience
- Interprets policies and analyzes details gathered to determine the best course of action
- Prioritizes contact of various parties associated with the claim, ensuring efficiency
- Gathers details on status and treatment needed of those injured in an accident
- Evaluates and settles unrepresented bodily injury claims
- Determines liability (who’s at fault for the damages);Negotiates with customers and other insurance carriers
0-5 years of experience
- Effectively plans, coordinates, conducts and reports on Claims Recovery Quality Control activities; makes recommendations to address deficiencies and conducts related training and presentations as needed on identifying, assessing, and executing recovery.
- Act as a liaison between A&H claims and subrogation department as well as recovery counsel.
- Works with underwriting (business lines) to cross train with claims for effective recovery.
- Coordinate/facilitate between claimants, providers, attorneys and insurance carriers.
- Assign and direct internal and external resources as required.
- Dedicated to national accounts/insureds.
- Handle and monitor recovery of overpayments.
0-5 years of experience
- Review & evaluate insurance claims & supporting documentation.
- Correspond with clients & follow each guideline through the lifetime of the claim.
- Serve as person of contact for file inquires, updates, balance adjustments, etc.
- Document all written correspondence from claimants, attorneys, outside insurance carriers, etc.
0-5 years of experience
- Filed subrogation demands and sought reimbursement from third party insurance carriers for no-fault property damage claims.
- Requested and obtained additional information or documents such as police reports, rental receipts and written/recorded statements in order to expedite claim processing.
- Finalized claim settlements, processed reimbursement checks and forwarded unsettled claim files to litigation or arbitration.
0-5 years of experience
- Typing and data entry
- Supported claim adjusters by completing and managing varying claim tasks.
- Filed reports and customer information.
- Other administrative duties as assigned.
0-5 years of experience
- Liaison for clients seeking reimbursement from responsible uninsured or underinsured motorists
- Claims processing, police reports, denial letters, witness statements, wage garnishments, Bank attachments and license suspensions
- Collections payment arrangements, settlements, demand packets- letters
0-5 years of experience
- Understand the fundamentals of health insurance subrogation including rights of recovery/reimbursement associated with Medicare, Medicaid, Self-funded ERISA and Non-ERISA plans.
- Review preliminary information provided by plan members, identify any missing accident details and develop a course of action to gather missing information and potential sources of recovery
- Analyze and identify plan members’ role(s) in accidents and determine possible sources of recovery based on their involvement
- Validate liability and first party insurance claim information including handling adjuster’s contact information, claim status, availability of coverage, accident-related injuries, and health plan members’ treatment status
- Make verbal and submit written requests for reimbursement to med-pay, no-fault, and PIP carriers. Requests for copies of med-pay/no-fault payment ledgers when necessary
- Contact workers’ compensation insurance carriers to confirm handling adjuster’s contact information, if the claim has been accepted or contested, and accident-related injuries
- Place all adverse parties on notice of our intent to subrogate. Assert appropriate Notices of Lien based on plan funding source
- Request and review ISO Match Reports to determine relevancy of information listed
- Appropriately document all activities including all conversations with all parties related to the case, incoming and outgoing correspondence, current file updates, subrogation analysis, applicable state laws and statutes
- Maintain a calendar diary to manage workload. Set timely and specific diaries for follow-up and correspondence
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Subrogation Specialist
Last edited by: Gabriela Barcenas, CONTENT STRATEGIST -
Gabriela Barcenas
CONTENT STRATEGISTGabriela is a Certified Professional Resume Writer (CPRW) and career adviser. With 10 years of digital media experience and five years of resume writing expertise, her publication history includes fashion, education, travel, social justice, equitable design and career advice.
