Subrogation Specialist

Remote

Full Time

Third Party Recovery

Experienced

Umpqua Health is recruiting for a Subrogation Specialist to support our cost recovery efforts and ensure appropriate reimbursement for services impacted by third-party liability. In this role, you’ll manage subrogation claims related to medical services and community-based programs, working collaboratively with insurers, legal teams, and healthcare providers to recover expenses from responsible third parties. Your expertise in insurance claims and regulatory compliance will play a critical role in maintaining financial accountability while supporting our mission to deliver high-quality, community-centered care.

Your Impact:

Investigate and manage third-party liability claims to identify opportunities for cost recovery through subrogation.
Collaborate with insurance carriers, legal representatives, healthcare providers, and community partners to initiate and resolve subrogation cases.
Analyze patient, medical, and insurance documentation to build strong, compliant subrogation files that support recovery efforts.
Facilitate negotiations and settlements with third-party insurers or responsible parties to recover healthcare-related expenses.
Track subrogation cases through resolution, ensuring timely follow-up, accurate documentation, and compliance with applicable laws and healthcare regulations.
Maintain detailed records of recovery efforts and financial outcomes, supporting transparency, audit readiness, and process optimization.
Monitor trends in subrogation activity and provide insight into potential areas for process improvement or increased recovery opportunities.
Ensure strict adherence to HIPAA guidelines and relevant state and federal subrogation laws throughout all case activities.
Provide regular reports and updates on subrogation case statuses, recovery metrics, and operational performance.
Perform other duties as assigned to support Umpqua Health’s Vision, Mission, and Organizational Values.

Your Credentials:

High school diploma or equivalent required; Bachelor’s degree in Healthcare Administration, Insurance, Business, or a related field preferred.
Minimum of two (2) to three (3) years of experience in subrogation, insurance claims, or third-party liability management, preferably within a healthcare or public health setting.
Strong knowledge of healthcare insurance processes, subrogation best practices, and relevant legal and regulatory compliance standards.
Exceptional communication and negotiation skills, with the ability to work effectively with a wide range of stakeholders.
Proficient in reviewing and managing complex documentation and systems related to healthcare services and reimbursement.
Detail-oriented and organized, with strong analytical skills and the ability to manage multiple priorities in a fast-paced environment.
Technologically proficient, with experience using claims systems, data tracking tools, and Microsoft Office applications.
Demonstrated commitment to ethical standards and maintaining confidentiality in handling sensitive information.

About Umpqua Health

At Umpqua Health, we're more than just a healthcare organization; we're a community-driven Coordinated Care Organization (CCO) committed to improving the health and well-being of individuals and families throughout our region. Umpqua Health serves Douglas County, Oregon, where we prioritize personalized care and innovative solutions to meet the diverse needs of our members. Our comprehensive services include primary care, specialty care, behavioral health services, and care coordination to ensure our members receive holistic, integrated healthcare. Our collaborative approach fosters a supportive environment where every team member plays a vital role in our mission to provide accessible, high-quality healthcare services. From preventative care to managing chronic conditions, we're dedicated to empowering healthier lives and building a stronger, healthier community together. Join us in making a difference at Umpqua Health.

Umpqua Health is an equal opportunity employer that embraces individuals from all backgrounds. We prohibit discrimination and harassment of any kind, ensuring that all employment decisions are based on qualifications, merit, and the needs of the business. Our dedication to fairness and equality extends to all aspects of employment, including hiring, training, promotion, and compensation, without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected category under federal, state, or local law.

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Subrogation Specialist

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