As an integral member of the claims team for our Third-Party Administrator, you will have the responsibility to investigate, coordinate and evaluate the legal liability of any party involved in claims we receive. This position requires the candidate to work closely with our claims professionals, clients, and all related parties to obtain the necessary information to create subrogation recovery opportunities, coordinating the development of evidence to support subrogation recoveries and pursue these recoveries in accordance with legal statutes, policy provisions and client handling guidelines.Responsibilities:
- Manages pending of multi-line subrogation claims with multiple jurisdictions with a caseload of low to moderate complexity
- Reviews and evaluates new incoming subrogation claim referrals from adjusting staff, performs triage analysis, and aggressively pursues follow up activities
- Conducts investigations, verifies negligence scenarios, and completes fact gathering in support of recovery opportunity in a timely manner
- Documents a recovery strategy and action planning in a clear, succinct and fact-based manner in the claim log notes
- Notifies appropriate parties of intent to subrogate and prepares necessary documentation in accordance with state filing requirements
- Prepare materials, demand packages, and documentation on unsettled claims to communicate to claims professionals, clients, legal representatives, carrier partners, claimants, collection agencies and possible arbitration, if appropriate
- Exercises independent judgement and decision making within assigned authority on settlement of subrogation claims from self-insured clients and unbundled carrier partners
- Negotiate settlements with responsible parties and their representatives; if a settlement can't be reached, directs legal action or arbitration against responsible parties
- Assemble and analyze data relative to subrogation recognition, pursuit, and recovery with objective of ensuring optimal performance
- Maintain technical and regulatory expertise. Monitor judicial and legislative developments to promptly identify, analyze and communicate changes impacting recovery strategies
- Other duties as assigned
- Builds and leverages critical thinking and decision-making skills to gather, assess, analyze, question, interpret and understand key root issues
- High degree of judgment, critical thinking skills, and initiative to implement collection strategies
- Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards, and laws applicable to job responsibilities in the performance of work.
- 1-3 years of progressively responsible experience and working knowledge of handling Workers' Compensation, Automobile, General Liability and Property claims handling or subrogation recovery experience
- Multiple jurisdictional expertise with a knowledge of claims procedures, policies, state and federal laws, and insurance regulations preferred
- Understanding of medical terminology, physical damage repair and negligence laws are required
- Excellent verbal and written communication skills are necessary
- Demonstrated sound customer service and interpersonal skills, with the ability to communicate effectively and clearly with several internal and external parties are essential
- Decisive and organizational, ability to manage time and diaries effective and efficiently, with ability to prioritize work in a fast-paced environment are necessary
- Bachelor's Degree or equivalent experience is required; professional designations (CPCU, AIC, etc.) are a plus