Specialist, Subrogation

001 BlueCross and BlueShield of South Carolina; Columbia (SC); On-site; USD 38,000 - 48,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement plan

Life Insurance

Paid Time Off (PTO)

On-site cafeterias

Fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is looking for a dedicated individual to join our team in a full-time capacity. This role involves managing a caseload of approximately 500 claims and pursuing subrogation and workers compensation recoveries.

The ideal candidate will possess strong analytical skills, be able to handle sensitive information, and work well in a collaborative environment. We offer a comprehensive benefits package and are committed to diversity and inclusion.

Qualifications

• 1 year of claims processing, customer service or research/analysis experience.

Responsibilities

• Analyzes laws, regulations, and contract language.
• Reviews claims history to determine lien amounts.
• Negotiates with attorneys and liability carriers.
• Reconciles monies recovered.
• Maintains public relations with internal units.

Skills

Analyzes laws and regulations

Evaluates issues

Handles confidential information

Investigates claims

Proposes claims adjustments

Works claims caseloads

Organizational skills

Time Management

Good writing skills

Teamwork

Education

High School Diploma or equivalent

Job description

Summary

Identifies and pursues subrogation and workers compensation recoveries. Manages a workload of approximately 500 cases and the collection of approximately $1,000,000 annually.

Position Purpose

Identifies and pursues subrogation and workers compensation recoveries. Manages a workload of approximately 500 cases and the collection of approximately $1,000,000 annually.

Location & Working Hours

This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-4:30PM. This role is located at 4101 Percival Road, Columbia, SC 29229.

Sponsorship

This position is not eligible for sponsorship now or in the future.

What You’ll Do

Analyzes laws, regulations, and contract language concerning the pursuit of subrogation and workers compensation reimbursements. Reviews claims history to determine the lien amount and assert lien against interested parties based on applicable laws. Negotiates with attorneys, liability carriers, and members for final settlement. under supervision of managing attorney, argues relevant subrogation laws concerning Erisa pre-emption, common fund rule, made whole rule, and other doctrines. Reconciles monies recovered. Maintains effective public relations with external and internal units by providing accurate and prompt responses to inquiries.

To Qualify for This Position, You'll Need the Following

Required Education: High School Diploma or equivalent

Required Work Experience: 1 year of claims processing, customer service or research/analysis experience.

Required Skills and Abilities:

• Analyzes laws, regulations and contract language
• Evaluates issues and develops recommendations
• Handles confidential and sensitive information
• Investigates assigned claims
• Proposes claims adjustments and refunds
• Works claims caseloads

Preferred Skills and Abilities:

• Organizational skills
• Time Management
• Good writing skills
• Teamwork

Comprehensive Benefits Package Includes the Following

• Subsidized health plans
• Dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On-site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Why should you join the BlueCross BlueShield of South Carolina family of companies?

Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina… and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Veterans Welcome!

BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full‑time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy‑related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case‑by‑case basis. We participate in E‑Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.