Subrogation Supervisor
4 days ago
Las Vegas
Job Description UNITE HERE HEALTH serves over 200,000 workers and their families in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity! The Subrogation Supervisor will investigate, negotiate, and report, all subrogation cases referred to the Las Vegas Fund office. The Subrogation Supervisor oversees and supports the subrogation team in identifying, pursuing, and resolving subrogation claims. This role ensures efficient recovery processes, mentors team members, monitors performance metrics, and serves as a liaison between departments and external partners to drive successful recovery outcomes. Responsibilities include coordinating workflow, improving procedures, maintaining compliance with the Fund’s subrogation policies and applicable laws and regulations, all in support of minimizing financial loss due to claims. ESSENTIAL JOB FUNCTIONS AND DUTIES • Provide daily guidance and oversight to subrogation coordinators and specialists, • Monitors third party administrator for compliance with the Fund’s subrogation policy and provide oversight of support systems related to subrogation investigation, tracking, and reporting, • Assign cases, monitor workload distribution, and ensure timely and accurate processing of subrogation files, • Act as a subject matter expert and point of escalation for complex or disputed cases, • Train and mentor new and existing team members on best practices and Fund subrogation policies, • Performs the daily functions of the Subrogation Specialists, • Recommend and implement process improvements to enhance recovery rates and operational efficiency, • Prepare and analyze ad-hoc reports on recovery trends, KPIs, and team performance for management review, • Ensure HIPAA-compliant communications and secure handling of member data, • Review and approve case files, submit the EOM reports, and prepare refund request for overpaid subrogation liens, • Responsible for coordinating with Fund Management, Fund Counsel and/or Local Counsel with respect to litigation, settlement, and any legal issues that may arise, • Open files for all subrogation cases once completed subrogation and repayment agreement have been received, • Communicate with participant’s representing attorneys and third parties requesting liens by analyzing treatment records and claims, • Refer cases to the Fund when attorneys are unable to secure settlements or recover funds, • Adhere to established guidelines for lien follow-ups within 60 days to optimize recovery outcomes, • Draft required communications as needed to external and internal counsel and participants as applicable, • Report monthly, or as requested, to Fund management on case load, • Provide recommendations of cases to refer to Local Counsel and/or Fund Counsel which require legal review and opinion or attorney involvement, • Operate within compliance of Fund’s subrogation policies and applicable laws and regulations, • Plans, analyzes, and evaluates programs and services, operational needs, and fiscal constraints, • Supervises, leads, and delegates work and coaches, mentors, develops employees, • Analyzes problems, identifies, and develops alternative solutions, projects consequences of proposed actions, and implements recommendation/solutions, • Recommends hires and promotions, directs, and evaluates employment decisions for all assigned positions, • Assists with developing and coordinating policies and procedures, • Exemplifies the Fund’s values in leading and fostering a respectful, trusting, and engaged culture of inclusion and engagement ESSENTIAL QUALIFICATIONS • 7-10 years of related experience in subrogation and healthcare claims, • 1-2 years of supervisory experience, • Strong knowledge of CPT and ICD-10 coding, • Associate's degree in related field or equivalent work experience, required (bachelor’s degree preferred), • Excellent attention to detail, time management, organizational skills and ability to maintain and monitor large number of case files, • Excellent analytical skills, • Communication, negotiation and interpersonal skills, • Intermediate level Microsoft Office skills (PowerPoint, Word, Outlook) and Microsoft Excel Salary range for this position: Salary $58,300 - $72,900. Actual base salary may vary based upon, but not limited to: relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location. Work Schedule (may vary to meet business needs): Monday~Friday, 7.5 hours per day (37.5 hours per week) as a hybrid employee. We reward great work with great benefits, including but not limited to: Medical, Dental, Vision, Paid Time-Off (PTO), Paid Holidays, 401(k), Short- & Long-term Disability, Pension, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP). #LI-Hybrid