Subrogation Specialist - Remote in VA

Overview

Sentara Health Plan is currently hiring a Subrogation Specialist – Remote in VA. This full‑time, permanent position requires 40 hours per week, with standard work hours 8 a.m. – 5 p.m. EST, Monday through Friday. The role is performed remotely in Virginia.

The Subrogation Specialist protects and enforces reimbursement/subrogation rights of Sentara, recovers funds from responsible parties, and maintains the confidentiality of provider health information and records.

• Review medical and pharmacy claims to determine which paid claims relate to an accident or injury and should be included in the lien for reimbursement; negotiate settlement of liens, coordinate payment, finalize recovery, release the lien, and interact with legal counsel.
• Research, analyze, and interpret member contract language, state and federal law as they apply to submitted claims; apply contract provisions and statutes to gather factual circumstances and determine cases where subrogation and recovery are possible.
• Conduct data analysis associated with data mining, Service Forms, Coordination of Benefits, and Subpoenas to maximize recoveries; serve as the key point of contact for receipt, response, and distribution of Subrogation Service Forms and individual referrals to the department.
• Develop and maintain subrogation files, assembling member information, claims paid, potential third‑party wrongdoer, and third‑party claims data.
• Identify members who have a duty to reimburse Sentara for paid medical or pharmaceutical claims; communicate and correspond with members, attorneys, and other parties on a routine basis.

• Associate’s Degree

• 3 years of relevant work experience in subrogation claims or other adjuster/claims work.
• Prior paralegal or healthcare experience preferred.
• Working knowledge of Virginia law preferred.
• Strong proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, etc.).

• Medical, Dental, Vision plans
• Adoption, Fertility and Surrogacy Reimbursement up to $10,000
• Paid Time Off and Sick Leave
• Paid Parental & Family Caregiver Leave
• Emergency Backup Care
• Long‑Term, Short‑Term Disability, and Critical Illness plans
• Life Insurance
• 401(k)/403(b) with Employer Match
• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
• Student Debt Pay Down – $10,000
• Reimbursement for certifications and free access to complete CEUs and professional development
• Pet Insurance
• Legal Resources Plan
• Opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria are met.

Sentara Health Plans provides coverage to close to one million members in Virginia, offering a full suite of commercial products, including employee‑owned and employer‑sponsored plans, individual and family health plans, and Medicare and Medicaid coverage. The plan features a robust provider network and programs to support members with chronic illnesses, wellness, and integrated behavioral health services.

To apply , please go to and use the keyword search JR-94456.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its nearly 30,000‑member workforce. In support of our mission “to improve health every day,” this is a tobacco‑free environment.