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
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:
- 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.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
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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 minorities, females, disabled individuals and 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 physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, 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.
What We Do
For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state. We are the largest insurance company in South Carolina. We are also the only one that has an A+ Superior A.M. Best rating. We are one of the nation's leading government contract administrators. We operate one of the most sophisticated data processing centers in the Southeast and have a diverse family of subsidiary companies.
Our full-time employees enjoy benefits like a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave and holidays, wellness programs and education assistance. If you are a full-time employee in the National Guard or reserves, we will cover the difference in your pay if you are called to active duty. BlueCross has a dedicated corporate culture of community support. Our employees are some of the most giving in the country. They support dozens of nonprofit organizations every year.
If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!
