Job Description

Company :Highmark Inc.Job Description :JOB SUMMARYThis job supervises and coordinates day to day activities administering the cost control provision of coordination of benefits and other party liability workers compensation subrogation and motor vehicles.ESSENTIAL RESPONSIBILITIESCommunicate effectively.Effectively supervise all assigned personnel.Coordinate any claim or inquiry backlog distribution for regular and overtime work both interdepartmentally and companywide.Research quality issues and respond to error assessments.Subject matter expert for benefit plan and claims processing issues implementation of new groups and products and transition meetings.Interpret and apply regulations across all lines of business handled within the unit.Review negotiate and approve compromises and fee authorizations for fully insured business in conjunction with the legal department.Other duties as assigned or requested.QUALIFICATIONSMinimumHigh School Diploma or GED2 years experience in a claims or customer service environment1 year experience leading or supervising othersSKILLSKnowledge of multiple processing systems and workflowsKnowledge of claims processing methodologiesAbility to interpret all government regulations.Language (Other than English):NoneTravel Requirement:0% - 25%PHYSICAL MENTAL DEMANDS and WORKING CONDITIONSPosition TypeOffice-basedTeaches / trains others regularlyOccasionallyTravel regularly from the office to various work sites or from site-to-siteRarelyWorks primarily out-of-the office selling products/services (sales employees)NeverPhysical work site requiredYesLifting: up to 10 poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to 50 poundsRarelyDisclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties responsibilities and qualifications required of employees to do this job.Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.As a component of job responsibilities employees may have access to covered information cardholder data or other confidential customer information that must be protected at all times. In connection with this all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Companys Handbook of Privacy Policies and Practices and Information Security Policy.Furthermore it is every employees responsibility to comply with the companys Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws rules and regulations as well as company policies and training requirements.Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race color age religion sex national origin sexual orientation/gender identity or any other category protected by applicable federal state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race color age religion sex national origin sexual orientation/gender identity protected veteran status or disability.EEO is The LawEqual Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated files/employers/poster screen reader optimized.pdf )We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process please contact number below.For accommodation requests please contact HR Services Online at HRServices@highmarkhealth.orgCalifornia Consumer Privacy Act Employees Contractors and Applicants NoticeReq ID: J217319