Subrogation Examiner

Elevance Health • City of Pewaukee, WI

10d • Remote

About The Position

Subrogation Examiner Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. A proud member of the Elevance Health family of companies, Carelon Subrogation, formerly Meridian Resource Company, is a health care cost containment company offering subrogation recovery services. Schedule: Monday - Friday; 8:30am-5:00pm Eastern Time 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.

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.

Responsibilities

• 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.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees