Senior Subrogation and Recovery Specialist
Job title: Senior Subrogation and Recovery Specialist
Job description: The role is responsible for the end-to-end process, from identifying possible recoveries (through, coordination of benefits, subrogation, or others) to collecting the money from third parties. The role is responsible for reporting on all the recovery opportunities identified for all Bupa Global Latin-American product suites, initiated, and recovered. The role is highly analytical and must have strong communication skills.
The role is responsible for identifying collection opportunities related to claims, contacting third parties (including other health insurance companies, banks, vendors, and clients) to identify the recovery possibility, follow up on agreed terms / recoveries and follow through to verify that the money was received by the Accounts Receivable department from Bupa.
The role will work closely with cross functional teams and follow up any pending items from other departments.
The role will also support the Financial Crime team in the evaluation of Sanctions alerts for the Bupa Travel business. This process is highly sensitive and must be served in very short turnaround times.
Role Responsibility * Subrogation Specialist is responsible for training and assisting our claims analysts to identify claims in which a third party/ies is/are responsible for a loss to an insured,
- Responsible for identifying collection opportunities related to claims, contacting third parties (including other health insurance companies, banks, vendors, and clients) to identify the recovery possibility, follow up on agreed terms / recoveries and follow through to verify that the money was received by the Accounts Receivable department from Bupa.
- Reviews claim files to identify, evaluate, analyse, and interpret subrogation potential; coordinates appropriate steps to secure evidence and ensure pursuit, development and recovery of claims.
- Research paid claims based on pre-defined criteria and possible “red flags” indicators.
- Responsible for coordinating the communication with the responsible third party/ies, the insured, the carrier representative, as well as appropriate legal representatives, and for facilitating recovery of claims payments from the third party/ies, as warranted.
- Answer subrogation-related inquiries and coordinates with other departments, insurance adjustors, attorneys, and members.
- Responsible to interact with the Legal team to review, initiate and follow up on Subrogation / collection activities involving Legal.
- Interacts with policyholders, claimants, agents, and internal staff to request, document, and recommend the necessary information to close a case.
- Per Company guidelines/criteria, refers applicable subrogation files for legal counsel; if additional investigation is necessary, works with legal counsel to coordinate investigation efforts.
- Efficiently and effectively utilizes claims data to accurately maintain and record subrogation files and reports.
- Continuously identifies ways of widening the possibilities to recover claim costs from third parties.
- Will contact third parties world-wide, if applicable
- Responsible of reviewing Sanctions Alerts for Travel on an ongoing basis.
- Specialist will be responsible for first level review and investigation of sanctions alerts generated in the LexisNexis system to ensure proper disposition, escalation, and documentation of alerts.
- Lexis Nexis alerts must be reviewed following the process / instructions received by Financial Crime.
- Lexis Nexis must be monitored regularly during the day for new alerts
- Sanction alerts must be dispositioned in a timely fashion to maintain compliance with applicable requirements
The Ideal Candidate * Bachelor’s degree required
- Bilingual English / Spanish Required, with strong verbal and written communication in English.
- Requires 3 to 5 years of related experience (Collection, Provider Management or Negotiation, Health Care, Banking or Legal Services)
- Knowledge of Sanctions / OFAC requirements. Ability to understand the risks of dealing with sanctioned parties.
- Strong skill sets in the following areas:
- Effective decision-making
- Strong analytical skills
- Keen attention to detail
- time management/working under tight deadlines
- information and financial review and analyses
- problem analyses/solving
- active listening
- asking productive questions with an ability to apply learned information to a variety of related or similar situations.
- Ability to apply sound judgement and make timely decisions under pressure
- Advanced knowledge in Excel or other Tracking software
- Exposure to International Travel insurance subrogation / third party recoveries desired.
About the Company
We are a health insurer and provider. With no shareholders, our customers are our focus. We reinvest profits into providing more and better healthcare for the benefit of current and future customers.
Bupa’s purpose is longer, healthier, happier lives and making a better world.
Here you’ll be welcomed. We champion diversity and we understand the importance of our people representing the communities and customers we serve. You’ll find an inclusive environment where you can be yourself and where everyone is driven by the same purpose – helping people live longer, healthier, happier lives and making a better world.
Bupa Global is the international health insurance division of . We provide customers who want premium international coverage with products and services to access the healthcare they need anytime, anywhere in the world, whether at home or when studying, living, travelling or working abroad.
Bupa Global has offices around the world including London and Brighton (UK), Miami (USA), Copenhagen (Denmark), Dubai (UAE, in partnership with OIC), and Hong Kong (China) as well as regional offices in mainland China, Singapore, Egypt, Mexico, the Dominican Republic, Bolivia, Brazil, Panama, Guatemala and Ecuador.
Timescales for reviewing applications will differ between regions, but you will always receive a response to your application. The recruitment process itself will vary per role and region, but you will be updated along the way via phone and email (so please look out for these!). To view what stage of the process your application is currently at, you can also and view your dashboard.
If you are invited to an interview, a member of the resourcing team will be able to advise you on what to expect. This will vary in region, but will likely include an initial phone or digital interview, followed by one or more of the following depending on the role: Core capability interview; Technical/function specific interview; Online profiling assessment; Presentation, written task, role play; Assessment centre.
If your application is successful and you’re invited to join the team, the resourcing team will guide you through your on boarding journey.
Should you require any reasonable adjustments to be made or facilities provided to enable you to attend an interview, please do not hesitate to contact us prior to the interview at , so we can make adjustments accordingly.
Location: Santo Domingo
Job date: Fri, 22 Oct 2021 06:39:45 GMT
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