Subrogation Professional

Become a part of our caring communityThe Subrogation Professional 2 investigates accident, injury, and claim events to determine whether Humana may have the right to recover claim payments from another responsible party. This role gathers information from members, providers, insurance adjusters, attorneys, and other parties; reviews claim payments; creates liens; and negotiates repayment when appropriate. You will report to a Supervisor.Review new accident, injury, or claim events to determine whether subrogation or other party liability may applyContact members, providers, insurance adjusters, attorneys, and other involved parties by phone or email to gather claim detailsInvestigate the facts of the accident or claim, including:What happenedDate and location of the accident or claimWho was at faultAll parties involvedInsurance coverage informationAttorney or legal representation informationSettlement status, when applicableUse available resources to support the investigation, such as police reports, state websites, claim systems, provider information, and other approved resourcesIdentify and document responsible parties and provide appropriate notice of Humana’s potential recovery interestReview claim payment information to determine amounts paid by Humana related to the accident or claimCreate, update, and maintain liens based on eligible paid claimsCommunicate lien information to attorneys, adjusters, and other appropriate partiesNegotiate lien repayment amounts with attorneys or other parties as neededRemain calm, professional, and confident during difficult conversations, including negotiations or disputed claimsUse emotional intelligence to manage conversations with members, attorneys, adjusters, and other parties in a respectful and effective mannerDocument all conversations, research, actions taken, decisions made, and claim updates thoroughly and accurately in the appropriate systemsFollow up on outstanding claims, liens, documentation, settlement information, and recovery opportunitiesBalance daily workload and create an effective workflow to manage competing prioritiesManage a high-volume workload while meeting monthly productivity, quality, and recovery expectationsUse multiple computer systems and applications to research claims, document activity, and complete daily workMultitask effectively as work may come from multiple sources throughout the dayWork independently while knowing when to escalate complex issues or seek guidanceUse your skills to make an impact Required

Qualifications

2+ years of subrogation claims handling experience in healthcare, property and casualty, or worker's compensation insurance2+ years phone customer service experience dealing with escalated situations involving attorneys, providers, and/or members etc.Microsoft Office proficiency - ability to create forms, reports, and documents in Word and ExcelExperience multitasking within several computer systems throughout the dayBasic proficiency with computers, email, phone systems, and data entryStrong verbal and written communication skillsPreferred

Qualifications

Undergraduate degreeExperience with healthcare claims, medical insurance, auto insurance, workers’ compensation, or liability claimsExperience creating, reviewing, or negotiating liensExperience communicating or negotiating with attorneys, adjusters, or insurance carriersExperience researching claims using police reports, state websites, insurance portals, or other investigative resourcesAdditional InformationWork at Home

Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours40Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting.

The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$58,700 - $68,200 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of

Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive

Benefits

that support whole-person well-being. Associate

Benefits

are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our

Benefits

, Humana provides medical, dental and vision

Benefits

, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 07-01-2026About usAbout Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.

These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity EmployerIt is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job

Requirements

. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.Originally posted on Himalayas