MagnaCare is seeking experienced Subrogation Specialists to help identify and investigate all possible Third-Party Liability claims. This role requires attention to detail, critical thinking, and investigative skills. This position is office-based, requiring work to be performed on-site.
Primary Responsibilities
Investigate, analyze, and handle subrogation claims.
Communicate effectively with members and ensure timely responses to calls and correspondence in accordance with required timeframes.
Adhere to established guidelines and timeframes for escalations and followups.
Ensure timely handling of mail and correspondence.
Closely monitor inventory of pending liens, claim holds, etc.
Conduct thorough analysis and investigation of medical claims history and related documentation.
Follow and meet departmental-workflow, quality, and production standards.
Facilitate professional claim processing, including applying medical policies, contractual provisions, and operational procedures to ensure precise adjudication and adjustments.
Generate correspondence, such as letters and questionnaires, to gather additional information from customers and providers; may also initiate phone inquiries.
Perform focus audits, create ad hoc reports and result summaries for management and/or client.
Demonstrate adaptability and willingness to provide backup support across various departments and roles as needed.
Essential Qualifications
Subrogation experience for labor unions is preferred.
Strong knowledge of healthcare contracts, medical terminology, and claims processing procedures.
Prior experience processing claims is preferred.
Minimum 1 year of experience in medical billing, claims adjudication, or a related role.
Excellent written and verbal communication skills, with the ability to manage inquiries professionally and efficiently.
Strong analytical skills, with the ability to research and resolve complex claim issues.
Proficiency in Microsoft Office (Word and Excel).
Ability to meet production and quality standards while managing multiple priorities.
Strong problem-solving skills and the ability to maintain professionalism under pressure.
Bilingual Spanish preferred.
At MagnaCare LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect, and increasing diversity, inclusion, and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all your unique abilities.
For more than 30 years, MagnaCare LLC has been a trusted partner in delivering flexible, customized solutions for self-insured organizations. As a national third-party administrator (TPA), we combine proprietary technology, network expertise, and a deep understanding of labor to help our clients achieve their goals while supporting the people they serve.
Our focus on labor means we work closely with funds, Taft-Hartley Trusts, and other self-insured groups to deliver tailored solutions that go beyond the basics. From health plan administration and eligibility management to contribution accounting, we provide the tools and support organizations need to succeed. With specialized offerings such as flexible network administration, direct contracting, in-house medical and care management, and workers’ compensation programs, we create benefit plans that address unique needs with precision.
