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Other Party Liability Specialist II The candidate will review Accidental Injury Questionnaires to identify possible third party liability or workersâ€™ compensation cases. Will prepare investigative reports and supporting documentation for subrogation reimbursement and recoveries. Receive and respond to correspondence from members, attorneys, and adjusters regarding subrogation, workersâ€™ compensation, medical malpractice and product liability cases. Initiate corrective actions including claims recoveries when duplicate payments or payments have been made in error. Report to: Supervisor, Other Party Liability. Must have 3+ yearsâ€™ experience in health insurance, customer service, claims, collections/subrogation or health-related industry.. Knowledge of: Medical and healthcare terminology; Claims processing, Plan benefit descriptions, Facets and Brand systems, Basic accounting principles BCI fully insured policy/contract benefits, Self-funded plan benefits administered by BCI, Federal Employee Program (FEP) benefits, Medicare Advantage policy/contract benefits and provider contracts, subrogation, workersâ€™ compensation, personal injury, and medical malpractice laws. Skills in Strong Written and verbal communication is essential. Knowledge of subrogation, workersâ€™ compensation, personal injury, and medical malpractice laws is preferred. Legal or paralegal experience is preferred.
Job ID #: 1769
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