Subrogation Specialist, Sr. jobs in Kentucky

The Phia Group provides, amongst other things, claim recovery services for health benefit plans. When a health benefit plan pays medical bills, and we later discover someone else should have paid those medical bills, The Phia Group – on behalf of the health plan – will seek to recover the funds.

The Subrogation Attorney is responsible for providing in-house legal support, research on all issues impacting the Company (as an employer and service provider), handling the most complicated cases and assignments, and playing the role of liaison for high ranking clientele.

Attorneys are called upon to handle both the highest-level assignments, as well as act as a face of the Company, attending client events, industry conferences, and conducting webinars, conference calls and sales gatherings.

At The Phia Group, whose mission is to provide high quality yet affordable healthcare to American employees and their dependents, you can look forward to not only exceptional benefits for yourself but also being immersed in a company that has been named one of USA Today’s top workplaces for 2024. We believe that this distinction, which stems from the fourth-annual survey co-sponsored by Energage and USA Today, reflects our unwavering commitment to upholding an internal culture of inclusivity, enjoyment, and empathy for our valued employees.

Essential Duties and Responsibilities

• Handle complex recovery cases transferred to recovery department for further review of reimbursement entitlement.
• Respond to staff inquiries, questions and issues involving cases.
• Monitor applicable regulations, rules, and laws.
• Perform industry topic research and reporting and provide research and draft analysis.
• Monitor and advise on Company specific legal issues, as well as transactions and disputes on a variety of cases.
• Draft agreements and review Third Party agreements.
• Attend industry related networking events.
• Coordinate the outsourcing of work to local counsel on complex recovery cases.
• Responsible for protecting company assets from unauthorized access, disclosure and/or modification; as well as comply with the organization's information security policies

Experience and Qualifications

• Degree from an accredited law school required.
• Admittance to a State Bar.
• Knowledge of latest developments in healthcare, subrogation and ERISA laws.
• Knowledge of privacy laws and understanding of the need and requirements regarding patient and client confidentiality.
• Past work within or related to the healthcare and insurance industries preferred.

Working Conditions / Physical Demands

Sitting at workstation for prolong periods of time. Extensive computer work. Workstation may be exposed to overhead fluorescent lighting and air conditioning. Fast paced work environment. Operates office equipment including personal computer, copiers, and fax machines.

This job description is not intended to be and should not be construed as an all-inclusive list of all the responsibilities, skills or working conditions associated with the position. While it is intended to accurately reflect the position activities and requirements, the company reserves the right to modify, add or remove duties and assign other duties as necessary.

External and internal applicants, as well as position incumbents who become disabled as defined under the Americans with Disabilities Act, must be able to perform the essential job functions (as listed here) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis.