Claims Recovery Representative - WC - Subrogation
Claims Recovery Representative - WC - Subrogation
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Job Description
Job Description
Job Title: Claims Recovery Representative WC Subrogation
Job Summary
A Claims Recovery Representative is responsible for managing lower to moderately complex subrogation claims within the workers compensation line of business. This position focuses on identifying liable third parties investigating claims pursuing recoveries and negotiating settlements. The role requires a strong understanding of subrogation processes workers compensation laws and recovery techniques. Success in this role contributes to the organizations financial outcomes through the effective resolution and collection of claim recoveries.
Responsibilities
- Manage a caseload of lower to moderate exposure workers compensation subrogation claims ensuring prompt and accurate resolution.
- Conduct investigations to identify liable third parties through interviews evidence collection and collaboration with internal/external experts.
- Issue demands and liens initiate recovery efforts and negotiate settlements with third parties or their insurers.
- Draft and submit arbitration demands in accordance with arbitration forum guidelines and deadlines.
- Evaluate open and closed workers compensation claims for subrogation potential; assist in training claims teams to recognize recovery opportunities.
- Maintain organized and timely file documentation using claims management systems; monitor statutes of limitations and manage file closures.
- Coordinate with attorneys claimants policyholders and external carriers to resolve subrogation matters.
- Refer delinquent accounts to collections and prepare claims for legal or criminal restitution when appropriate.
- Complete oversight tasks for recovery referrals handled by third-party administrators.
- Stay current with applicable statutes case law and policy language through continued learning and research.
Qualifications/Requirements
- Bachelors degree required.
- Adjuster license and confirmation of home state license required.
- Minimum 3 years of experience handling workers compensation claims.
- At least 1 year of experience handling subrogation claims.
- Knowledge of workers compensation statutes liability principles and insurance recovery processes.
- Proficiency in claims management software and Microsoft Office especially Excel.
- Strong critical thinking and decision-making abilities.
- Excellent verbal and written communication skills.
- Effective time management and organizational skills especially in a remote work setting.
- Strong interpersonal and negotiation skills.
Disclaimer: Please note that this job description may not cover all duties responsibilities or aspects of the role and it is subject to modification at the employers discretion.
#LI-BC1
Required Experience:
Unclear Seniority
Employment Type
Full-Time
