As a Subrogation Analyst, the professional will identify legal liability, and pursue, negotiate, and settle subrogation collection. A well-drafted Subrogation Analyst Resume mentions the following core duties – researching paid claims, answering inquiries, coordinating with other departments, insurance adjustors, attorneys, and members; identifying and researching of subrogation claims, assisting in the recovery of overpayments for duplicate coverage, worker’s compensation, and no-fault claims; and interacting with policyholders, claimants, witnesses, and underwriters; and collecting information needed to determine when an on-going investigation is necessary.
The nature of the job demands the following skills and abilities – strong knowledge of various personal lines products, property-related principles; practices, and processes, and terminology; strong communication skills, and a good understanding of personal umbrella products. A bachelor’s degree and equivalent experience are commonplace among job applicants.
Summary : Seeking an opportunity with a progressive company, that demonstrates a high level of integrity, by adding my more than 25 years of customer service experience in training, implementation and problem solving strengths to their organization.
Skills : Sales, Managerial Support, Customer Service, Project Management, Training Delivery, Training & Development.
Description :
Managed 2,000 open liability cases and supported 14 associates.
Settled 10 cases on a weekly average, responded to 125 letters/ phone calls weekly and annually recovered $2.2M in negotiated 3rd party liability settlements.
Strengthened communication as a liaison for Legal, In-house Counsel, attorney offices, health care providers, other carrier representatives, Customer Service, Group Representative, Stop Loss, Finance and Critical Inquiries to assist in resolving escalated issues.
Responsible for analysis of medical and pharmaceutical claims based on hold codes, denial codes, ICD-9 and ICD-10 diagnosis codes.
Led analyst for self-funded groups and stop loss coordinator.
Reduced Civil Remedies 10% by creating and implementing a support service for the litigation department.
Attended court hearings, mediations, depositions and trials as the company's representative.
Experience
10+ Years
Level
Senior
Education
Bachelor Of Science
Subrogation Analyst Resume
Headline : Productive and results-oriented Subrogation Analyst Professional possesses knowledge and skills in Business Management, leadership and communications. Will excel in a fast-paced environment where demonstrated organizational and time-management skills are the keys to success. Education and experience have provided working knowledge in the following key areas: Insurance Subrogation, Patient Advocacy, Management, Marketing and Advertising, Sales/Customer Service.
Skills : Microsoft Office, Mailing Machines Ex USPS, FedEx.
Description :
Researched and Investigated Insurance claims for healthcare subrogation rights.
Read and interpreted case law as it pertains to state laws governing subrogation and coordination or insurance benefits.
Negotiated settlements with attorneys and Insurance carriers on behalf of United Healthcare for benefits paid relating to accidents.
Reviewed the subrogation decisions and efforts of the adjuster and the subrogate to determine if all avenues of subrogation were exhausted.
Reviewed claim files to evaluate recovery potential and open subrogation file on those with adequate potential.
Taken appropriate steps for the development, pursuit, and recovery of claims.
Evaluated completeness and accuracy of documentary evidence as to amount of damage and liability.
Experience
5-7 Years
Level
Executive
Education
Business Management
Subrogation Analyst Resume
Summary : Subrogation Analyst is Reviewing and evaluating accident or incident reports, individual claims, medical, legal or other documents relating to subrogation, Responding to inquiries regarding claim recovery issues, Identifying, monitoring, and evaluating claim data to determine relatedness and reimbursement amounts.
Skills : Skip tracer, Case Management.
Description :
Investigated, evaluated and settled claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
Established Quality and Operational Standards, Resolve complex, severe exposure claims, using high service oriented file handling.
Verified and analyzed data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
Conferred with legal counsel on claims requiring litigation.
Contacted or interviewed claimants, doctors, medical specialists, or employers to get additional information.
Maintained claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
Presented cases and participate in their discussion at claim committee meetings.
Experience
10+ Years
Level
Senior
Education
BS In Industrial Technology
Subrogation Analyst Resume
Objective : Subrogation Analyst professional with expertise in investigating, negotiating and settling complex claims and complaints. Exceptional innovative thinker and tactical decision-maker. Excellent analytical and problem-solving skills, with a proven track record of exceeding expectations and thriving in a fast-paced environment. Results-focused and passionate about doing what's right for the business. Strong values of teamwork and partnership, with a talent for cultivating positive internal and external relationships for an organization.
Skills : Planning, Documentation Skills.
Description :
Reviewed and evaluated complex auto, medical payments, property and product liability claims to identify subrogation potential.
Reviewed files for adequacy of investigation and measure of damages to initiate collection.
Made recommendations to clients whether to pursue arbitration, collection or litigation.
Participated in discussions and negotiated liability decisions, requests for reductions in subrogation liens and authorized settlements within defined authority with insurance adjusters and attorneys.
Communicated with clients regarding various facets of the subrogation process.
Acted as a liaison between the client and attorney on medical payments and PIP claims.
Documented and tracked all ongoing verbal and written correspondence in various databases.
Experience
2-5 Years
Level
Executive
Education
B.A. In Mass Communication
Subrogation Analyst Resume
Headline : Subrogation Analyst with 6 years of experience in Analyzing, interpreting, and applying plan language, contracts, case law and various statutes or regulations, Preparing and maintaining case files, correspondence, legal documents, and other information related to subrogation claims, Coordinating actions involving accounting for payments received.
Skills : Exceptional Typist, Legal Research, Medical Terminology, Trial Preparation, Witness Interviewing, And Strong Communication .
Description :
Provided subrogation recovery support by identifying potential recovery cases, collecting historical data related to the case, investigating and evaluating the elements impacting the payments in question.
Negotiated settlements directly with providers or members to avoid litigation if possible.
Conducted legal research pertinent to the jurisdiction each case was governed under.
Handled all Minnesota workers' compensation interventions on behalf of both Medica Health Plans and United Healthcare.
Attended and participated in hearings, settlement conferences, pre-trials, and mediations on behalf of Medica Health Plans and United Healthcare.
Consistently met and surpassed personal and departmental recovery goals.
Formally recognized for excellent performance during subrogation recovery support.
Experience
5-7 Years
Level
Executive
Education
BA In Legal Studies
Subrogation Analyst Resume
Objective : Pursuing a career with a dynamic and growing company. Solid communicative and interpersonal skills identified. Excellent negotiation skills combined with a driven, positive personality, and persistence to achieve organization and personal goals. Strong ability to develop, maintain, and grow relationships.
Skills : Microsoft Office, Multi-line Phone Systems, Adobe Suite,.
Description :
Recovered funds paid to claims billed to major health plans for which another insurer is liable.
Confidential communication with patients, insurers, attorneys, paralegals, and providers.
Kept detailed records of such.
Interpreted, created, and transmitted legal documents in compliance with HIPAA regulations.
Analyzed Plan documents and billed procedures in order to contrast them with state laws to determine rights of recovery or lack thereof.
Developed working knowledge of ICD-9 coding.
Studied subrogation laws specific to each of the fifty states.
Experience
2-5 Years
Level
Junior
Education
Bachelor Of Fine Arts
Subrogation Analyst Resume
Objective : Over eleven years banking and point-of-sale card processing industry experience in the restaurant and retail fields with excellent soft skills and an expert in customer relations with inbound and outbound calls to clients. After 6 months as a Petroleum Technical Support Analyst, was chosen to work with relationship managers in the field as a Sales Support Analyst.
Skills : Proficient in Spanish, Analyst.
Description :
Provided subrogation services to healthcare companies, which included Aetna and Exxon.
Required knowledge of the subrogation and reimbursement laws in all 50 states in addition to the Erisa laws that may override them.
Communicated with daily outbound calls to patients, attorneys, healthcare facilities, and insurance companies to verify details of the accident and injuries to determine if subrogation or reimbursement possible.
Initiated subrogation process through formal letters to at fault parties and their insurance.
Negotiated settlements with attorneys.
Managed inventory of over 400 patient files.
Praised by supervisors and team members for precision handling large case volume.
Experience
2-5 Years
Level
Executive
Education
Bachelors Of Science
Subrogation Analyst Resume
Summary : Nineteen years experience in the health insurance industry with a focus on subrogation. Have succeeded working in a goal oriented environment and facilitated the efforts of the team to obtain unit goals. Proven ability with handling stressful situations, and assertive negotiation of files for our clients, while exemplifying professionalism.
Skills : Team Work, Modelling, Law-Enforcement
Description :
Researched and investigated potential subrogation files, obtaining relevant information, and identify every potential source of recovery required to place all parties on timely notice.
Developed and monitored of files to timely settlement, by maintaining follow up with all parties as appropriate.
Negotiated of files to settlement of our client's interest, with the best possible recovery.
Completed of all settlement procedures and follow up to insure all recovery was made on file.
Experienced with a large number of liability claims.
Property, worker-ed compensation, medical malpractice and automobile.
Prepared cases for attorneys.
Experience
7-10 Years
Level
Management
Education
AA In Undergraduate
Subrogation Analyst Resume
Objective : Subrogation Analyst with a broad background in the office related field seeking a rewarding position. Longevity experience includes working at WEYCO (a third-party administrator of self-funded insurance) for 17 years which provided growth opportunity with progressive responsibilities; and National Healing Corporation (outpatient hyperbaric programs within hospitals) for 5 years.
Handled workers' compensation, auto accidents, product liability and property insurance claims.
Worked closely with physician offices.
Arranged payment plans and received and recorded recoveries.
Supervised Subrogation Analyst to ensure that Analyst followed Operational Standards and that Analyst complied with our Contractual cotracts with our clients.
Prepared reports to be submitted to company's data processing department.
Reviewed Attorney Represented and Litigated Files.
Determined proper approach to secure recovery.
Experience
2-5 Years
Level
Junior
Education
Bachelors
Subrogation Analyst Resume
Headline : Seasoned Subrogation Analyst professional with strong analytical skills and business acumen, with twenty plus years of healthcare insurance industry experience in: business analysis, project management, communications, continuous improvement methodology, user support, testing and reporting. Extensive knowledge of ICD9/ICD10 diagnosis code sets.
Skills : Customer Service, Security, Email.
Description :
Recorded and processed all recovery payments.
Subrogated for major Health Insurance Companies.
Prepared claim history reports on MS Excel utilizing MHS, IMS, RBMS, Diamond and Seibel Analytics.
Interpreted plan policies and applied to claims processed.
Investigated, researched and resolved third-party liability medical claims, determined where the liability should be placed, and saved clients thousands of dollars.
Communicated and worked closely with 25+ claims processors on subrogation issues.
Created informational subrogation PowerPoint presentations.
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