Subrogation and No-Fault Claims Associate

All about us

You likely know us as an insurance company, but that's just a portion of what we do. Hundreds of thousands of North Dakotans trust us to provide them with personalized service and unmatched access to care. It's a mission we take seriously.

We also work with entities throughout the state to challenge the cost and complexity of health care in North Dakota. This uncompromising goal requires caring, innovative people who are ready and willing to help create a new level of health and well-being in North Dakota and beyond.

Work environment

This opportunity is open to a remote, hybrid or in-office working arrangement out of the Fargo, ND office. We empower our employees to find a work style that is best for them. Learn more at Life at Blue | BCBSND.

Pay information

• Pay Level: 017
• FLSA Category: Nonexempt - Hourly
• Individual pay will be based on skills, experience, qualifications, location, internal equity, and other relevant factors.
• Opportunities for continued salary growth through a performance-based merit program.

A day in the life

The Subrogation Specialist is responsible for subrogating activities and assists in the recovery of overpayments.

Your responsibilities will include

• Processes subrogation, no fault, and other claims where third party liability may exist.
• Investigates claims, communicates with external insurance organizations on claim settlement statuses and prepares investigative logs for internal and external auditing purposes.
• Develops cases resulting from beneficiary and provider-initiated inquiries, internal referrals, personal research, and computer-generated reports.
• Educates members regarding their subrogation rights.
• Provides training and coaching for the team about new and updated guidelines that affect the department. Prepares documentation for training about new system releases, updates, and testing for the department.
• Reviews correspondence to determine the next appropriate action needed. Processes claim adjustments and resolves forms of overpayment recovery. Uses research to process and resolve provider and customer questions with varying complexities, then generates communication about claim status.
• Identifies which claims can be fully processed or need additional information, investigates alternative coverage information through collaboration with external parties, and utilizes organizational guidelines and reference materials to process claims appropriately.
• Monitors system generated reports used to complete tasks and ensures department timeliness and performance standards are met.
• Handles moderately complex issues and refers more complex issues to higher-level staff.

What you need to succeed

• A High School Diploma or GED with 1 year of experience in customer service or related experience is required.
• 3 years of healthcare, insurance, customer service or related experience with a strong knowledge of healthcare processes, practices, and administration.
• Be a problem solver with the ability to research, analyze and define methods, practices, and procedures to resolve issues.
• Self-starter with a high energy level, commitment to excellence, and a diligent work ethic.
• Ability to juggle multiple projects at a time, while maintaining sharp attention to detail.
• Clearly communicate and support employees in a variety of situations, while also being flexible and adaptable.
• A strong ability to prioritize and organize work with varying timelines for projects and daily work.

Equivalent combination of education, experience or training determined to be acceptable by Human Resources may be substituted, unless regulated by contract or program standards

Benefits

• Affordable medical, dental and vision coverage accepted throughout the United States
• Employer funded Lifestyle Spending Accounts, Health Savings Accounts and Health Reimbursement Arrangements
• Employer-paid life and disability insurance
• 401(k) retirement plan with company match and immediate vesting
• Paid holidays, paid time off (PTO), PTO donation program, and paid parental leave
• Voluntary benefits including Accident, Hospital Indemnity, Critical Illness, Term/Whole Life, Cancer Care Insurance, and more.

Additional company perks

• Robust mental health offerings including an Employee Assistance Program, Learn to Live, meQ.
• Comprehensive learning and development opportunities and an Educational Assistance Program.
• 16 hours of paid volunteer time with a $200 donation to a charity of your choice upon completion of all volunteer hours.
• Employee recognition, community initiative events and yearly company outings.
• Workplace flexibility offering different options for working arrangements and the freedom to make time for important commitments.
• Opportunities to connect through employee committees.

Equal opportunity employment

Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individual with Disabilities, as well as Sexual Orientation or Gender Identity.

For questions, please email careers@bcbsnd.com.

This job posting will be closed 3/28/2025 at 8:00 a.m. (CT). No further applications will be considered.