COB and Subrogation Specialist

Hi, we’re Gravie. Our mission is to create health benefits that actually benefit small and midsize businesses and their employees. Our innovative benefit solutions and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.

We’re looking for a COB and Subrogation Specialist. The Specialist is responsible for ensuring Gravie maximizes our medical cost recoveries from third parties with liability, such as automobile insurers and other health plans, while strictly complying with all applicable regulations, contractual requirements and Gravie policies.

You will:

• Ensure notifications of potential third-party liability for medical costs incurred by Gravie’s members (subrogation) received through various channels are effectively triaged, prioritized and tracked

• Maintain records of all open subrogation cases and ensure they are responded to within all applicable timeliness requirements

• Identify and share all claims related to potential third party liability

• Lead the negotiation and final settlement of subrogation claims to maximize Gravie's recovery, ensuring strict adherence to all applicable laws and internal policies.

• Identify opportunities for improvements in processes and/or opportunities to increase Gravie’s collections in subrogation cases and other coordination of benefits overpayments.

• Partner with payment integrity leadership on other projects and workflows, such as provider credit balance recoupments, as time permits

• Partner cross-divisionally on related processes and procedures. 

• Work to ensure technology and processes support the optimal workflow department-wide and interdepartmentally.

• Be comfortable with addressing escalated scenarios depending on business needs

• Be willing to maintain a flexible work schedule, based upon the needs of the business.

• Demonstrate commitment to our core competencies of being authentic, curious, creative, empathetic and outcome oriented.

You bring: 

• Experience with subrogation processes at a commercial health plan

• Strong organizational, interpersonal, and communication skills.

• Ability to collaboratively and professionally work with all types of individuals. 

• Ability to demonstrate a high level of attention to detail

• Ability to meet deadlines and manage multiple priorities simultaneously. 

• Ability to navigate ambiguity, shift gears comfortably, and decide and act without having the total picture.

• Proven ability to get results and thrive in an ever-evolving environment

• Ability to interpret and apply complex regulations as mandated by CMS, DPW, and PID as related to coordination of benefits, subrogation, and Medicare

Extra credit: 

• Previous start up company experience

Gravie: 

In order to create a more equitable and sustainable future for employer-sponsored health insurance, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package.

The salary range for this position is $46,125 - $61,500  annually. Numerous factors including, but not limited to, education, skills, work experience, certifications, etc. will be considered when determining compensation.  

Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, generous PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, transportation perks, education reimbursement, and paid paw-ternity leave.

A Little More About Us:

• We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.
• We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.
• Our clients love us. Customer satisfaction rates among employees using Gravie health plans consistently rank above 80% – nearly 40 points above the industry average.
• Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve. We may not be the right place for everybody, but if you get energized by doing work every day that focuses on putting consumers at the front of the line, we could be a great place for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.