Subrogation Professional

Become a part of our caring community The Subrogation Professional 2 investigates accident, injury, and claim events to determine whether Humana may have the right to recover claim payments from another responsible party. This role gathers information from members, providers, insurance adjusters, attorneys, and other parties; reviews claim payments; creates liens; and negotiates repayment when appropriate. You will report to a Supervisor. Review new accident, injury, or claim events to determine whether subrogation or other party liability may apply Contact members, providers, insurance adjusters, attorneys, and other involved parties by phone or email to gather claim details Investigate the facts of the accident or claim, including: What happened Date and location of the accident or claim Who was at fault All parties involved Insurance coverage information Attorney or legal representation information Settlement status, when applicable Use available resources to support the investigation, such as police reports, state websites, claim systems, provider information, and other approved resources Identify and document responsible parties and provide appropriate notice of Humana’s potential recovery interest Review claim payment information to determine amounts paid by Humana related to the accident or claim Create, update, and maintain liens based on eligible paid claims Communicate lien information to attorneys, adjusters, and other appropriate parties Negotiate lien repayment amounts with attorneys or other parties as needed Remain calm, professional, and confident during difficult conversations, including negotiations or disputed claims Use emotional intelligence to manage conversations with members, attorneys, adjusters, and other parties in a respectful and effective manner Document all conversations, research, actions taken, decisions made, and claim updates thoroughly and accurately in the appropriate systems Follow up on outstanding claims, liens, documentation, settlement information, and recovery opportunities Balance daily workload and create an effective workflow to manage competing priorities Manage a high-volume workload while meeting monthly productivity, quality, and recovery expectations Use multiple computer systems and applications to research claims, document activity, and complete daily work Multitask effectively as work may come from multiple sources throughout the day Work independently while knowing when to elevate complex issues or seek guidance Use your skills to make an impact. WORK STYLE Remote, work from home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS Typical business hours are Monday-Friday, 5 days/week, in the associate's home time zone. Required Qualifications 2+ years of subrogation claims handling experience in healthcare, property and casualty, or worker's compensation insurance 2+ years phone customer service experience dealing with escalated situations involving attorneys, providers, and/or members etc. Microsoft Office proficiency — ability to create forms, reports, and documents in Word and Excel Experience multitasking within several computer systems throughout the day Basic proficiency with computers, email, phone systems, and data entry Strong verbal and written communication skills Preferred Qualifications Undergraduate degree Experience with healthcare claims, medical insurance, auto insurance, workers’ compensation, or liability claims Experience creating, reviewing, or negotiating liens Experience communicating or negotiating with attorneys, adjusters, or insurance carriers Experience researching claims using police reports, state websites, insurance portals, or other investigative resources Additional Information Work at Home Requirements At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested Satellite, cellular and microwave connection can be used only if approved by leadership Associates 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 information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. #LI-LM1 Work at Home Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Scheduled Weekly Hours 40 Pay Range Pay Range The 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. $58,700 - $68,200 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline 10-29-2026 About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. #J-18808-Ljbffr