Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). * Participates in data collection/input into ...
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Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). * Participates in data collection/input into ...
Field Claims Adjuster - South Carolina
Columbia, SC · On-site +1
$60K - $80K/yr
Identify and recommend subrogation opportunities. * Utilize peer review as needed. * Review and ... This position is remote from your home, but you are required to service the assigned territory on a ...
Field Claims Adjuster - South Carolina
Columbia, SC · On-site +1
$60K - $80K/yr
Identify and recommend subrogation opportunities. * Utilize peer review as needed. * Review and ... This position is remote from your home, but you are required to service the assigned territory on a ...
Identify and recommend subrogation opportunities. * Utilize peer review as needed. * Review and ... Schedule: This position is remote from your home, but you are required to service the assigned ...
Identify and recommend subrogation opportunities. * Utilize peer review as needed. * Review and ... Schedule: This position is remote from your home, but you are required to service the assigned ...
... will be fully remote in South Carolina. The candidate may be required to report on-site for ... Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system ...
... will be fully remote in South Carolina. The candidate may be required to report on-site for ... Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system ...
... will be fully remote in South Carolina. The candidate may be required to report on-site for ... Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system ...
... will be fully remote in South Carolina. The candidate may be required to report on-site for ... Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system ...
Remote Subrogation information
What is a remote subrogation job?
Remote subrogation jobs involve investigating and pursuing the recovery of funds from responsible third parties, typically in insurance claims, while working from a remote location. Professionals in these roles review claim files, gather evidence, negotiate settlements, and communicate with clients and other parties electronically. These positions require strong analytical, negotiation, and communication skills, as well as knowledge of insurance policies and legal principles related to subrogation. Remote subrogation jobs offer flexibility and the ability to work from home, making them a popular option in the insurance industry.
What is a remote subrogation job?
Subrogation involves the transfer of rights and duties from one person or group to another, usually regarding a debt or insurance claim for an automobile, piece of property, or medical expense. Remote subrogation jobs allow you to complete your subrogation responsibilities while you work from home. Duties may differ depending on the position, but you may investigate and examine claims, evaluate a property, assess damage, decide liability, and handle the legal components. Some job titles include working as a remote subrogation specialist, a remote subrogation attorney, a remote subrogation examiner, and a subrogation analyst.
What are the key skills and qualifications needed to thrive as a remote subrogation specialist?
To thrive as a Remote Subrogation Specialist, you need a solid understanding of insurance claims processes, investigative skills, and typically an associate’s or bachelor’s degree in a related field. Familiarity with claims management software, Microsoft Office Suite, and sometimes industry certifications like AIC (Associate in Claims) are common technical requirements. Strong attention to detail, negotiation skills, and the ability to communicate effectively with clients and third parties are standout soft skills. These abilities are crucial for accurately identifying recovery opportunities, securing settlements, and ensuring successful claims resolution in a remote work environment.
What are some common challenges faced by remote subrogation professionals, and how can they be managed?
Remote subrogation professionals often encounter challenges such as coordinating effectively with clients, insurers, and legal teams across different locations and time zones. Managing digital documentation securely and ensuring prompt communication are crucial for success in this role. Utilizing robust case management software, maintaining organized digital records, and setting clear expectations for virtual collaboration can help address these challenges, enabling remote subrogation specialists to work efficiently while maintaining strong relationships with stakeholders.
What is the difference between Remote Subrogation vs Remote Claims Adjuster?
| Aspect | Remote Subrogation | Remote Claims Adjuster |
|---|---|---|
| Required Credentials | Insurance licenses, legal knowledge | Adjuster licenses, insurance knowledge |
| Work Environment | Remote, legal and insurance settings | Remote, insurance claims processing |
| Industry Usage | Insurance, legal recovery | Insurance, claims management |
Remote Subrogation focuses on recovering funds from third parties after an insurance payout, often requiring legal and insurance knowledge. Remote Claims Adjusters evaluate and settle insurance claims, handling a broader range of claims. Both roles are remote and industry-specific, but they differ in their primary functions and required expertise.
More about Remote Subrogation jobs
What are popular job titles related to Remote Subrogation jobs in Irmo, SC?
For Remote Subrogation jobs in Irmo, SC, the most frequently searched job titles are:
What job categories do people searching Remote Subrogation jobs in Irmo, SC look for?
The top searched job categories for Remote Subrogation jobs in Irmo, SC are:
What cities near Irmo, SC are hiring for Remote Subrogation jobs?
Cities near Irmo, SC with the most Remote Subrogation job openings:
Full-time
Medical, Dental, Vision, Retirement
Re-posted 2 days ago
Job description
Case Management - RN
Must have at least 4 years recent clinical nursing experience
Licenses -
Must have an active, unrestricted RN license in the State of South Carolina
#ZR
#INDGEN
Job at a Glance
Title: Medical Case Management Nurse
Location: Must live within 2 hours of Columbia, and be willing to work the first week on site for training
Contract:
Pay: $ 30/hour + optional medical, dental, vision, 401(k) match
Must have an active unrestricted RN license in the State of South Carolina
Overview
Reviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise, administrative policies, and established clinical criteria to service requests or provides health management program interventions. Utilizes clinical proficiency, claims knowledge/analysis, and comprehensive knowledge of healthcare continuum to assess, plan, implement, coordinate, monitor, and evaluate medical necessity, options, and services required to support members in managing their health, chronic illness, or acute illness. Utilizes available resources to promote quality, cost effective outcomes.
Key Responsibilities
- Provides active case management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals.
- Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions.
- Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits.
- Provides telephonic support for members with chronic conditions, high risk pregnancy or other at risk conditions that consist of: intensive assessment/evaluation of condition, at risk education based on members’ identified needs, provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behavior change and increase member program engagement.
- Performs medical or behavioral review/authorization process. Ensures coverage for appropriate services within benefit and medical necessity guidelines.
- Utilizes allocated resources to back up review determinations.
- Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.).
- Participates in data collection/input into system for clinical information flow and proper claims adjudication.
- Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but is not limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal).
- Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans.
- May identify, initiate, and participate in on-site reviews.
- Serves as member advocate through continued communication and education.
- Promotes enrollment in care
Must have at least 4 years recent clinical nursing experience
Licenses -
Must have an active, unrestricted RN license in the State of South Carolina
#ZR
#INDGEN