Specialist, Subrogation

001 BlueCross and BlueShield of South Carolina; Columbia (SC); On-site; USD 52,000 - 72,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k with company match

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a Subrogation & Workers' Compensation Recoveries Specialist to manage a caseload of ~500 cases and pursue approximately $1,000,000 in annual recoveries. The role is based in Columbia, SC, and requires attention to legal and contractual details.

Responsibilities include analyzing laws, reviewing claims histories, negotiating settlements, and applying doctrines such as ERISA pre-emption and made-whole.

Qualifications

• Requires High School Diploma or equivalent.
• At least 1 year of claims processing, customer service, or research/analysis experience.
• Ability to analyze laws, regulations, and contract language; evaluate issues; handle confidential information; investigate claims; propose adjustments.

Responsibilities

• Analyzes laws, regulations, and contract language concerning subrogation and workers' compensation recoveries.
• Reviews claims history to determine lien amounts and assert liens.
• Negotiates settlements with attorneys, liability carriers, and members.
• Under supervision, argues subrogation doctrines (ERISA pre-emption, common fund rule, made-whole rule).
• Reconciles monies recovered.
• Maintains prompt communications with internal and external parties.

Skills

Analyzes laws regulations

Evaluates issues

Confidential information

Investigates claims

Proposes adjustments

Works claims caseloads

Education

High School Diploma

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.

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!

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:

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

We Prefer That You Have The Following:

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

Our 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.

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.

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.

Welcome Here’s Your Smart Career Move

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re 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 that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!