Subrogation Examiner

Elevance Health • Meridian, ID • 2w ago

Location: This position will work remotely. The Ideal candidate will live within 50 miles of our Elevance Health PulsePoint locations; Meridian, Idaho and Columbus, GA.

The Subrogation Examiner is responsible for researching and examining routine health claims that may be related to Third Party Liability, Workers' Compensation and other subrogation/reimbursement recovery cases.

How you will make an impact:

Initiates calls to groups, insurance companies, attorneys, members and others as necessary to determine if claims have potential for reimbursement from another party.

Responds to inquiries regarding information on injury claims.

Utilizes various research methods and vendor systems to gather information.

Works with subrogation staff, other departments and outside clients to assist with the recovery process.

Prepares written communications.

Reviews diagnostic and procedure codes to determine claims relevant to each case.

Reviews internal systems/applications for various information needs.

Assists with small scale special projects.

Minimum requirements:

Requires a minimum of 1 year of inbound or outbound call experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

BA/BS degree is preferred

Resource Optimization: Experience in efficient handling and recovery of claims allow the organization to allocate resources more effectively, reducing financial losses associated with unclaimed reimbursements, preferred.

Stakeholder Communication: This role serves as a vital communication link between various stakeholders, including insurance companies, attorneys, and members, ensuring that all parties have the necessary information to process claims correctly, experience in these responsibilities are preferred.

Compliance and Accuracy: Experience in reviewing diagnostic and procedure codes and utilizing various research methods are crucial for maintaining compliance with legal and regulatory standards and ensuring the accuracy of claims, preferred.

Support for Subrogation Processes: The position supports the subrogation staff and collaborates with internal and external clients, enhancing the overall efficiency and success of reimbursement recovery processes, experience in these responsibilities are preferred.

Operational Efficiency: By assisting with small-scale projects and responding to inquiries, this role helps streamline operations, improve processes, and support broader departmental goals, experience in these responsibilities are preferred.

Overall, the role is justified by its contribution to the organization's financial health, operational efficiency, and commitment to compliance and stakeholder engagement, experience in these responsibilities are preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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