Subrogation Analyst (Healthcare)

EXL • Full-time • Remote (United States) • $16 - $19 / hour • 1d ago

About EXL Health

We leverage Human Ingenuity and domain expertise to help clients improve outcomes, optimize revenue and maximize profitability across the healthcare ecosystem. Technology, data and analytics are at the heart of our solutions. We collaborate closely with clients to transform how care is delivered, managed and paid.

EXL Health combines deep domain expertise with analytic insights and technology-enabled services to transform how care is delivered, managed, and paid. Leveraging Human Ingenuity, we collaborate with our clients to solve complex problems and enhance their performance with nimble, scalable solutions. With data on more than 260 million lives, we work with hundreds of organizations across the healthcare ecosystem.

We help payers improve member care quality and network performance, manage population risk, and optimize revenue while decreasing administrative waste and reducing health claim expenditures. We help Pharmacy Benefit Managers (PBMs) manage member drug benefits and reduce drug spending while maintaining quality. We help provider organizations proactively manage risk, improve outcomes, and optimize network performance. We provide Life Sciences companies with enriched data, insights through advanced analytics and data visualization tools to get the right treatment to the right patient at the right time.

This is a Remote Full-time opportunity

This position requires the Subrogation Specialist to process a paperless health insurance subrogation caseload by investigating potential cases and pursuing med-pay, no-fault, liability, and workers’ compensation recoveries.

Responsibilities include, investigating new potentials cases, placing outbound calls as well as submitting correspondence to health plan members, insurance companies, and attorney offices. The Subrogation Specialist coordinates efforts with other members of the subrogation team to maximize recovery in accordance with EXL’s Subrogation Policies and Procedures.

Complying with HIPAA regulations as well as EXL’s HIPAA and Information Security policies and procedures, including required training and incident reporting.

RESPONSIBILITIES

Learn and understand fundamentals of health insurance subrogation, including basic health plan contractual provisions that apply to the reimbursement efforts.
Review, Identify and develop subrogation opportunities by gathering missing information and potential sources of recovery.
Place parties of interest on notice
Organize and structure investigations to work in priority order using the tools provided.
Respond timely to all electronic, written, and verbal communications.
Log and maintain detailed and accurate records.
Access and pull benefits from clients’ health claim systems.
Pursue worker’s compensation, third party liability, first party uninsured and underinsured recovery, worker’s compensation, med-pay coverage, and no-fault recoveries.
Engage advice and/or help of legal manager to proactively resolve cases.
Ensure compliance of state and federal laws
Adhere to settlement authority levels.
Maintain department productivity and quality standards.
Sensitivity to privacy in accordance with HIPAA guidelines

Required Skills

Working knowledge of Microsoft Word, Excel, internet research skills
High School or equivalent education level

Preferred Requirements

1+ years subrogation experience
1+ years claims experience.
1+ years heavy call volume support experience

Professional Skills

Developed customer service skills.
Strong organizational and time management skills
Ability to work independently and as part of a team.

What We Offer

EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.

From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants.

You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth.

We provide guidance/ coaching to every employee through our mentoring program where in every junior level employee is assigned a senior level professional as advisors.

Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.

EEO/Minorities/Females/Vets/Disabilities

To view our total rewards offered click here —> https://www.exlservice.com/us-careers-and-benefits

Base Salary Range Disclaimer: The base salary range represents the low and high end of the EXL base salary range for this position. Actual salaries will vary depending on factors including but not limited to: location and experience. The base salary range listed is just one component of EXL's total compensation package for employees. Other rewards may include bonuses, as well as a Paid Time Off policy, and many region specific benefits.

Please also note that the data shared through the job application will be stored and processed by EXL in accordance with the EXL Privacy Policy.

Application & Interview Impersonation Warning – Purposely impersonating another individual when applying and / or participating in an interview in order to obtain employment with EXL Service Holdings, Inc. (the “Company”) for yourself or for the other individual is a crime. We have implemented measures to deter and to uncover such unlawful conduct. If the Company identifies such fraudulent conduct, it will result in, as applicable, the application being rejected, an offer (if made) being rescinded, or termination of employment as well as possible legal action against the impersonator(s).

EXL may use artificial intelligence to create insights on how your candidate information matches the requirements of the job for which you applied. While AI may be used in the recruiting process, all final decisions in the recruiting and hiring process will be taken by the recruiting and hiring teams after considering a candidate’s full profile. As a candidate, you can choose to opt out of this artificial intelligence screening process. Your decision to opt out will not negatively impact your opportunity for employment with EXL.