Erika Davis
Midfield,AL
Summary
A versatile, collaborative, accomplished, and knowledgeable professional with a successful track record as an HR Benefits Administrator with an experience of well over 24 years. Outstanding organizational and problem-solving skills. Highly collaborative with a talent for building productive relationships that allow smooth functioning while driving others towards excellence and attaining business goals. Possess verifiable leadership, interpersonal, and communication skills that help put across things with a crisp point. A remarkably successful mentor to peers and colleagues, owing to exceptional people’s skills. Have a solid track record in achieving the set goals and delivering personal best at every step of the way to provide optimal results.
Overview
21
21
years of professional experience
Work History
Subrogation Analyst
Blue Cross And Blue Shield Of Tennessee
09.2022 - Current
- Exhibited strong analytical skills in evaluating claim files for potential third-party liability exposure, significantly reducing financial losses for clients.
- Investigated intricate accident scenarios using expert knowledge in liability laws to establish fault accurately, leading to higher recovery amounts.
- Collaborated with legal teams to prepare comprehensive documentation for litigation proceedings, resulting in favorable judgements for clients.
- Minimized financial risk by promptly closing out inactive files after thorough investigation and assessment of potential recovery options.
- Enhanced claim recovery rates by thoroughly analyzing case information and identifying subrogation opportunities.
- Demonstrated exceptional attention to detail in reviewing complex claims documents, uncovering discrepancies that led to successful subrogation actions against at-fault parties.
- Improved negotiation outcomes with insurance carriers by conducting detailed research on policy coverages and loss history.
- Developed strong professional relationships with external stakeholders, fostering collaboration on complex cases involving multiple parties and interests.
- Supported continuous improvement initiatives by sharing insights from trend analysis, helping identify areas for operational enhancement within the department.
Subrogation/Workman Compensation Analyst
Blue Cross Blue Shield of Alabama
01.2012 - Current
- Reviews proper notification of subrogation rights for quality, accuracy, and timeliness to internal or external
- Assists attorneys and insurance companies regarding accident liability and subrogation interest
- Prepares cases and communication with attorneys and insurance adjusters
- Actively uses knowledge of the subrogation process, legal terminology, and applicable case law to negotiate settlements with attorneys and insurance adjusters
- Prepares cases for court and processing adjustment recoveries
- Negotiates settlements with attorneys and insurance adjusters
- Determines equitable distribution of funds based on individual’s case
- Monitors the disposition of ongoing cases and communication with attorneys and insurance adjusters
- Works on special projects as required
Benefits Specialist
Blue Cross Blue Shield of Alabama
01.2004 - 01.2012
- Answered phone calls and emails from employees and physician offices
- Worked closely with Platform Delivery and Data Analysts, EBRC, Client Service Managers, Implementation Specialists, and external vendors while providing excellent service and deliverables
- Responsible for the timely servicing of an assigned list of clients
- Supported and educated employees and managers on benefit plans, including medical, dental, vision, Medicare summary plan descriptions, and COBRA
- Researched and assisted with claims and billing issues, filing appeals, and other duties as assigned
- Answered questions regarding Medicare part A and B benefits and coverage
- Communicated daily with health care vendors to resolve issues regarding members' benefits
- Responded to members' inquiries regarding the processing and rejection of Medicare claims
- Provided an explanation of deductibles and coinsurance eligibility
- Managed administrative processing of benefits
- Created Standard Operating Procedures for the department and conducted the training
- Created correspondence letters in SCC format throughout various Blue Cross Blue Shield’s departments
Education
Bachelor of Science - Management of Human Resources
Faulkner University
Montgomery, AL01.2009
Skills
- Employee Benefits
- Subrogation and Workman Compensation
- Benefits Administration
- Client Relations
- Workman Compensation
- Benefits Training
- Open Enrollment
- Written and Oral Communication Skills
- Subrogation and Litigation Claims
- Vendor Management
- BCOL
- MRO
- ITS CLAIMS
- Claims Processing
- PAIRS
- RMS System
- FEP DIRECT & DORS
- MS Office
Timeline
Subrogation Analyst
Blue Cross And Blue Shield Of Tennessee
09.2022 - Current
Subrogation/Workman Compensation Analyst
Blue Cross Blue Shield of Alabama
01.2012 - Current
Benefits Specialist
Blue Cross Blue Shield of Alabama
01.2004 - 01.2012
Bachelor of Science - Management of Human Resources
Faulkner University
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