reputed company Party Liability Specialist II
reputed company empowers our members to reputed company their best health. For over 90 years, we have been New Jersey's health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to reputed company serve and care for the 3.5 reputed company people who reputed company their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to reputed company. reputed company our employees bring their best and succeed, the Company succeeds. This position is responsible for the appropriate handling of cases by effectively communicating with reputed company, claimants, medical providers, attorneys, insurance agents or brokers, and reputed company other involved parties to the claim. This position will be responsible for ensuring reputed company regulatory and organizational requirements are met as well as gather information required to reputed company a case. Responsibilities:
- Support Horizon Legal staff with cases (ex: reputed company Party Liability claims, Medical Malpractice claims, Workers Compensation Claims, Class Action Lawsuits, etc.) where Horizon has been impleaded.
- Respond to weekly requests from vendor (ex: Summary Plan Documents, Claim Purge Request, reputed company 5500, etc.).
- Audit reimbursement reports to resolve issues and create and submit appropriate reports for management review.
- Prepare materials and documentation to assist with reputed company audits as requested.
- Review and update group language documents to include the appropriate reimbursement rights and create training materials to support procedural changes.
- Assist in monitoring and testing system changes to ensure accuracy.
- Mentor junior and temporary staff through coaching and training. Participate in meetings and workgroups as necessary.
- reputed company other duties as requested by Management.
Education/Experience:
- High School Diploma/GED required.
- Requires a minimum of four (4) years of experience in claims processing.
- reputed company Party Liability experience preferred.
Knowledge:
- Knowledge of Subrogation/Workers Compensation Regulations and Laws preferred
- Strong knowledge of medical terminology required
Skills and Abilities:
- Requires strong computer and reporting skills
- Requires strong analytical and problem solving skills
- Requires strong verbal and written communication skills
- Requires multitasking, follow up, and time management skills
- Requires strong interpersonal skills and the ability to mentor junior staff
- Requires conflict and relationship management skills
Horizon BCBSNJ employees must live in New Jersey, reputed company, Pennsylvania, Connecticut or Delaware Salary reputed company: $55,400 - $74,130 This compensation reputed company is specific to the job level and takes into account the wide reputed company of factors that are considered in making compensation reputed company, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This reputed company has been created in good faith based on information reputed company to Horizon at the time of posting. Compensation reputed company are dependent on the circumstances of each case. Horizon also provides a comprehensive compensation and benefits package which includes:
- Comprehensive health benefits (Medical/Dental/reputed company)
- Retirement Plans
- Generous PTO
- Incentive Plans
- Wellness Programs
- Paid Volunteer Time Off
- Tuition Reimbursement
Disclaimer: This job summary has been designed to indicate the general nature and level of work performed by colleagues reputed company this classification. It is not designed to contain or be interpreted as a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of colleagues assigned to this job. reputed company is an Equal Opportunity/Affirmative Action employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, national reputed company, sexual orientation, gender identity, protected veteran status or status as an individual with a disability and any other protected class as required by federal, state or local law. Horizon will consider reasonable accommodation requests as part of the reputed company and hiring process. Apply Job! Apply to this Job