Subrogation Manager
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Job Location:
Bloomington, IN - USA
Monthly Salary:
Not Disclosed
Posted on:
13 days ago
Vacancies:
1 Vacancy
Job Summary
HealthPartners is hiring a Subrogation Manager. The Subrogation Manager is responsible for overseeing the endtoend subrogation operations for the health plan including identification investigation recovery and collaboration with internal and external partners. This role ensures accurate detection of thirdparty liability optimizes recovery outcomes strengthens compliance with regulatory requirements and drives process efficiency across the subrogation lifecycle.
MINIMUM QUALIFICATIONS:
Education Experience or Equivalent Combination:
- Bachelors degree or equivalent experience in insurance healthcare administration or related field.
- 5 years of experience in healthcare subrogation payment integrity claims or recovery operations.
- Strong knowledge of ICD10CM EOB review accident claim indicators and payer subrogation processes.
- Experience leading teams or managing vendor relationships.
- Strong analytical skills with ability to interpret coding documentation and legal/contract language.
- Excellent communication and negotiation skills.
PREFERRED QUALIFICATIONS:
- Education Experience or Equivalent Combination:
- Licensure/ Registration/ Certification:
- Certification in claims subrogation (e.g. CPIP AIC) Paralegal is a plus
- Knowledge Skills and Abilities:
- Experience with Medicaid or Medicare TPL programs.
- Prior work with systembased detection tools (e.g. flags coding algorithms recovery vendors).
- Working knowledge of legal terminology related to settlements liens and thirdparty liability.
ESSENTIAL DUTIES:
(35%) Operational Management
- Lead daily subrogation operations including case intake validation investigation prioritization and recovery efforts.
- Develop and maintain workflows that improve identification of liability indicators such as external cause codes accident details workers compensation and autorelated injuries.
- Monitor case inventory productivity metrics and recovery pipelines to achieve established financial targets.
(20%) Leadership and Team Development
- Manage subrogation staff or vendoraligned teams.
- Provide coaching performance feedback and training documentation review and process adhere
(15%) Data Analytics & Technology Enablement
- Collaborate with Payment Integrity Claims and Clinical teams to enhance detection logic data mining rules and systemdriven triggers.
- Partner with IT or analytics teams to refine algorithms identifying potential thirdparty liability including missed opportunities.
Track and report key performance indicators (KPIs) root causes and recovery trends.
(15%) Vendor and Legal Oversight
- Manage relationships with subrogation vendors law firms and external recovery partners.
- Review vendor performance ensure SLAs are met validate case decisions and handle escalations.
Support legal review of complex cases settlements denials or disputes.
(10%) Cross Function Collaboration
- Work closely with Claims Operations to improve documentation completeness coding accuracy claim notes and accidentrelated indicators.
- Partner with Compliance Regulatory SIU and Finance to ensure alignment with state/federal requirements (e.g. Medicaid TPL Medicare coordination of benefits).
- Collaborate with Provider Relations to address provider inquiries or education needs related to accidentrelated claims.
(5%)Compliance & Quality Assurance
- Ensure regulatory adherence (ERISA Medicaid TPL state mandates) and maintain auditready documentation.
- Implement policy updates to address regulatory changes or audit findings.
LEADERSHIP RESPONSIBILITY:
Manages a team of Technical Subrogation Coordinators (5) Specialist Subrogation (2) Adm. Asst Senior (2)
Required Experience:
Manager
Key Skills
About Company
At HealthPartners we believe in the power of good – good deeds and good people working together. As part of our team, you’ll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work. We’re a nonprofit, integrated health care ... View more
