Subrogation Representative

Become a part of our caring community The Subrogation Representative 3 is responsible for identifying, investigating, and recovering funds from third parties who are legally liable for medical expenses. This role collaborates with attorneys and insurance professionals to assess liability and ensures accurate maintenance of Coordination of Benefits (COB) records. The associate supports compliance with subrogation policies and procedures while delivering high-quality service and maintaining confidentiality of member information. This position reports to a Supervisor within the Subrogation Department.Review and process subrogation correspondence and referrals within CRM systems (CAS/MTV) to determine appropriate handling under Third-Party Liability guidelinesValidate and match member information in CAS/MTV to ensure accurate case identification and documentationCreate and manage cases/events in Troveris to support recovery efforts from attorneys, insurance carriers, and other responsible partiesGenerate and send outbound correspondence using the EMME system in accordance with established workflows and timelinesHandle outbound calls using the Genesys system to communicate with third parties, obtain additional information related to correspondence received, and determine appropriate handling for cases involving non-pursuable member groupsAssess liability details and supporting documentation to identify subrogation opportunities and support recovery strategiesEnsure accurate documentation and timely updates across CRM, Troveris, and EMME systems for all case activitiesRoute cases appropriately to Subrogation, Other Party Liability, Coordination of Benefits, or other departments based on established guidelinesManage a high-volume, production-driven workload while meeting quality, accuracy, and compliance standards, including HIPAA and data privacy requirementsHumana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:Health benefits effective day 1Paid time off, holidays, volunteer time and jury duty payRecognition pay401(k) retirement savings plan with employer matchTuition assistanceScholarships for eligible dependentsParental and caregiver leaveEmployee charity matching programNetwork Resource Groups (NRGs)Career development opportunitiesUse your skills to make an impact  Required Qualifications1+ year of experience in healthcare and/or subrogation experience in the property, casualty, or worker's compensation fields2+ years of experience in a call center and/or production environmentExperience assessing severity of support requests and escalate based on severityMS Proficiency - Ability to create forms, reports, and documents in Word and ExcelTyping and computer navigation skills, including use of multiple computer applications simultaneouslyStrong organizational abilitiesPreferred QualificationsUndergraduate DegreeBilingual in English/SpanishClaims Processing ExperienceAdditional InformationWork-At-Home RequirementsTo ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates 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.Satellite, cellular and microwave connection can be used only if approved by leadership.Employees 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 informationOur Hiring ProcessAs part of our hiring process for this opportunity, we will be using an exciting interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule.If you are selected, you will receive correspondence inviting you to participate in a HireVue assessment. You will have a set of questions and you will provide responses to each question. You should anticipate this to take about 10-15 minutes. Your answers will be reviewed, and you will subsequently be informed if you will be moving forward to next round.#LI-LM1Travel: 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. $34,400 - $45,000 per year Description of BenefitsHumana, 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our Cen