Remote Claims Adjuster - Temp

Job Type: FTE - Full-Time
Monday - Friday (8:30 - 5:00)
Agency Specific Application Procedures:: ALL APPLICANTS MUST APPLY ONLINE at Answer all application questions completely. Supplemental questions are considered part of your official application. Please complete the state application to include all current and previous work history, salary and education. VETERAN APPLICANTS: Per SC §1-1-550 Veterans Preference: To claim Veteran's Preference, all eligible persons shall submit a DD Form214, Certificate of Release or Discharge from Active Duty at time of interview.
Upon successfully completing twelve (12) months of employment with the agency, employees may be eligible for a hybrid telecommuting schedule.
Veteran Preference Statement: South Carolina is making our Veterans a priority for employment in state agencies and institutions.

If you have previously applied, your application is still being considered.
The mission of the South Carolina State Accident Fund is to provide cost-effective, guaranteed workers' compensation insurance for state agencies and other governmental entities along with exceptional service to our state workers.
Ever thought about a career in state government but weren't sure where to start? The South Carolina State Accident Fund (SAF) is the leading provider of workers' compensation insurance in South Carolina. Today we serve nearly 600 employers and 200,000 state and local government employees throughout the state. The Claims Adjuster I, acting as a member of either the Santee Claims Team or Uninsured Employer Fund (UEF) Team with guidance from their Claims Team Manager (CM), will :

Provide workers' compensation benefits to injured workers and assist injured workers, policyholders, medical providers, attorney's and other stakeholders.
Record all accepted or denied body parts, lost time and/or return to work dates.
Determine compensability of claims and monitor all lost time periods substantiated by reviewing medical documentation and authorizes income replacement.
Authorize and submit medical payments and lost time payments in accordance with the SC Workers' Compensation Law .
Monitor all claims in accordance with agency policy and procedures as outlined in the Claims Training Manual.
Perform monthly claims reviews and a plans of action for all assigned claims and attend Claims Review Team meetings.
Recommend vocational rehabilitation or special medical management referrals.
Review cases with the CM and obtain authority for settlements following recommendations from the policyholder.
Negotiate settlements with claimant or attorney and prepare all necessary settlement documents/forms with CM oversight.
Review and monitor all reserves throughout the duration of claims.
With the assistance of internal legal counsel and the CM, read and review Workers' Compensation Commission orders.
Handle special projects and perform other duties as may be required and/or assigned.
THIS POSITION MAY REQUIRE OCCASIONAL IN-STATE TRAVEL.
A Bachelor's Degree.
Must possess or be able to obtain a valid South Carolina Insurance Adjuster's License within twelve (12) months of the start of employment.
Experience and/or knowledge in customer service, data entry, paralegal services, medical terminology, medical billing and/or coding, responding to telephone and email inquiries, and/or working with confidential information.
Experience and/or knowledge handling/adjusting/examining workers' compensation claims or insurance claims.
Experience and/or knowledge of workers' compensation laws, rules and regulations, insurance practices and procedures, medical terminology, costs of medical treatment, and/or methods and techniques for determining compensable wages.
Experience and/or knowledge of office practices, policies, procedures, rules, regulations and equipment.
Possesses the ability to communicate effectively both orally and in writing.
discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth, or related medical conditions
including, but not limited to, lactation), national origin, age (40 or older), disability or genetic information.
The State Accident Fund offers an exceptional benefits package for full-time (FTE) employees:

• Health, dental, vision, long-term disability, and life insurance for employees, the employee's spouse, and children;
• 13 paid holidays ;
• Employee Assistance Program : legal, financial, child/elder/pet care), and Unlimited assessment and referral services;
• State Retirement Plan and Deferred Compensation Programs ;
• Hybrid telecommuting schedules **; Eligibility to work remotely requires successfully completing a period of employment with the agency.

A copy of your transcript may be uploaded as an attachment to the application. The state of South Carolina offers eligible employees generous benefits, including health and dental insurance; retirement and savings plan options; Plus, work-life balance programs such as telecommuting and flexible work schedules are available to employees of some state agencies.

Insurance Benefits
Eligible employees may enroll in health insurance, which includes prescription coverage and wellness benefits. Other available insurance benefits include dental, vision, term life insurance, long term disability and flexible spending accounts for health and child care expenses.

Retirement Benefits
State employees are also offered retirement plan options, including defined benefit and defined contribution plans. Additionally, eligible employees may elect to participate in the South Carolina Deferred Compensation Program, which is a voluntary, supplemental retirement savings plan offering 401(k) and 457 plan options.

holiday, annual and sick leave; and discounts on purchases, travel and more.

Note: The benefits above are available to most state employees, with the exception of those in temporary positions. Employees in temporary grant and time-limited positions may be eligible for all, some or none of these benefits as benefits are associated with each position type. Supplemental questions are considered part of my official application. I have completed the state application to include ALL current and previous work history and education. High School Diploma or Equivalent
Bachelor's Degree
How many years of experience do you have in handling/adjusting workers' compensation claims or other insurance claims?

• How many years of experience/knowledge do you have related to workers' compensation laws, rules and regulations, insurance practices and procedures, medical terminology, costs of medical treatment, and/or methods and techniques for determining compensable wages?
• If selected, I understand that I must successfully complete a period of employment with the agency before becoming eligible to work a hybrid telecommuting schedule. I understand that prior to that, I would be required to work in the office located in Lexington, SC.

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