Title: Subrogation Coordinator Department: Claims
Union: Teamster 986 Grade: 23
Position Summary
The Subrogation Coordinator supports the resolution of complex subrogation claims ensuring accuracy efficiency and compliance with all regulatory and plan-specific requirements. This role assists with complex cases shares knowledge with team members and contributes to process consistency and team collaboration.
Has minimum necessary access to Protected Health Information (PHI) and Personally Identifiable Information (PII) by Job Description/Role.
Key Duties and Responsibilities
- Handles a high-volume caseload of complex or high-priority subrogation claims including third-party liability and workers compensation cases.
- Conducts in-depth claim analysis to determine subrogation potential and recovery opportunities ensuring alignment with legal standards and plan requirements.
- Coordinates with attorneys insurance carriers third-party administrators and internal stakeholders to facilitate resolution of disputed or litigated cases.
- Oversees the preparation and accuracy of detailed reports for leadership clients and legal counsel; identify trends and make strategic recommendations.
- Provides subject matter expertise on departmental procedures regulatory compliance and best practices related to subrogation.
- Conducts quality assurance reviews to ensure adherence to departmental standards and plan-specific guidelines.
- Supports internal audits compliance reviews and risk mitigation efforts through documentation verification and data analysis.
- Monitors regulatory and industry developments impacting subrogation and recommend policy or procedural updates as needed.
- Responds to inquiries from attorneys participants providers and plan representatives with professionalism discretion and expertise.
- Acts as a subject matter expert on subrogation policies regulatory requirements and departmental protocols ensuring consistency and compliance in complex case handling.
- Assists team development by providing ongoing mentorship technical guidance and expertise in navigating challenging or high-impact subrogation claims.
- Participates in process improvement projects collaborating with management to enhance operational workflows and system functionality.
- Performs other duties as assigned.
Minimum Qualifications
- High School Diploma or GED.
- Three years of progressively responsible experience in subrogation claims processing or a related healthcare or insurance environment.
- Advanced knowledge of subrogation workflows third-party liability and relevant federal and state regulations.
- Excellent written and verbal communication skills with the ability to interface effectively with attorneys external stakeholders clients and internal teams.
- Strong analytical thinking organizational skills and attention to details.
- Strong working knowledge of claims adjudication processes and the ability to identify recoverable claims through comprehensive case analysis.
Preferred Qualifications
- Associates degree in business Healthcare Administration Legal Studies or a related field.
- Experience working in a multi-client or third-party administrator (TPA) environment.
- Familiarity with lien resolution legal negotiations or settlement processes related to third-party liability claims.
- Prior experience supporting audits process improvements or system implementations in a subrogation or claims department.
*Please note this job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee of this job. Duties responsibilities and activities may change at any time with or without notice.
Working Conditions/Physical Effort
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift 15-25 pounds at times.
- Normal degree of physical effort in a typical office environment with comfortable constant temperatures and absence of objectionable elements.
- May be subject to interruptions.
- Must be able to have flexible work schedule when workflow requires.
- Meets established attendance and punctuality guidelines.
Disability Accommodation
Consistent with the Americans with Disabilities Act (ADA) and other applicable federal and state law it is the policy of Zenith American Solutions to provide reasonable accommodation when requested by a qualified applicant or employee with a disability unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment including the application process. If reasonable accommodation is needed please contact the Recruiting Department at and we would be happy to assist you.
Zenith American Solutions
Real People. Real Solutions. National Reach. Local Expertise.
We are currently looking for a dedicated energetic employee with the necessary skills initiative and personality along with the desire to get the most out of their working life to help us be our best every day.
Zenith American Solutions is the largest independent Third Party Administrator in the United States and currently operates over 44 offices nationwide. The original entity of Zenith American has been in business since 1944. Our company was formed as the result of a merger between Zenith Administrators and American Benefit Plan Administrators in 2011. By combining resources best practices and scale the new organization is even stronger and better than before.
We believe the best way to realize our better systems for better service philosophy is to hire the best employees. Were always looking for talented individuals who share our dedication to high-quality work exceptional service and mutual respect. If youre interested in working in an environment where people - employees and clients - really matter consider bringing your talents to Zenith American!
We realize the importance a comprehensive benefits program to our employees and their families. As part of our total compensation package we offer an array of benefits including health vision and dental coverage a retirement savings 401(k) plan with company match paid time off (PTO) great opportunities for growth and much much more!