Subrogation Specialist

ourhrconnect; Columbia (SC); On-site; USD 55,000 - 75,000; Full time

Job summary

BlueCross BlueShield of South Carolina is seeking a professional to identify and pursue subrogation and workers' compensation recoveries. The role manages about 500 cases and aims to collect around $1,000,000 per year in reimbursements.

The position is full-time in a typical office setting, with standard hours and location at 4101 Percival Road, Columbia, SC. Strong analytical and communication skills, plus experience with claims processing, are valued.

Qualifications

• High School Diploma or equivalent.
• 1 year of claims processing, customer service or research/analysis experience.
• 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.

Responsibilities

• Analyzes laws, regulations and contract language concerning the pursuit of subrogation and workers compensation reimbursements.
• Reviews claims history to determine lien amounts and assert liens against parties; negotiates with attorneys and liability carriers for final settlement.
• Maintains effective public relations with internal and external units by providing accurate and prompt responses to inquiries; reconciles monies recovered.

Skills

Subrogation knowledge

Analytical thinking

Data confidentiality

Claims investigation

Claims adjustments

Caseload management

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.

Description

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.

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 w