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
 

• 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 Work Experience:
• 1 year of claims processing, customer service or research/analysis experience.
• Required Education:
• High School Diploma or equivalent.
• 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

 

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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.