Senior Claims Adjuster (Workers Compensation)

External

Ourhrconnect · Columbia, SC

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About the role

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Independently investigates, evaluates, and negotiates the resolution of assigned claims within approved authority. Responsible for making recommendations for claim outcomes on claims exceeding level of authority. Logistics: Planned Administrators Inc. (PAI) - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a full-time position, with a Remote schedule ** , working an 8-hr. shift (40-hours/week) Monday-Friday 8:00am - 5:00pm with primary location at 17 Technology Circle Columbia SC, Columbia, SC 29203. ** Due to initial training period and some on-site activities, qualified, local candidates need apply.

Responsibilities

Manage (catastrophic, high exposure and complexity) caseload to ensure proactive disability, medical management and timely response to treatment recommendations, ongoing contact with the injured and insured, and a 100% closing ratio.

Provide direction and possible training to less experienced adjustors on less complex cases as needed.

Document activities, case action plans, settlements evaluations and requests for authorizations in the claim notes. Provide management and internal and external customers with documentation to support recommendations and claim status as required.

Utilize independent adjustors to assist in the evaluation of liability and for damages and reports findings. Reviews independent adjustor's reports and handles claim outcome.

To Qualify for This Position, You'll Need the Following:

Required Education: Bachelor's degree (see degree equivalency below)

Degree Equivalency : 4 years job related work experience or Associate's and 2 years job related work experience.

Required Work Experience: 4 years of area related adjusting experience.

Required Software and Other Tools : Microsoft Office.

Required Licenses and Certificates: Valid adjuster's license in required states or ability to acquire within 6 months-if required by resident state's department of insurance.

We Prefer That You Have the Following:

Strong organizational skills.

Solid ability and experience navigating multiple systems.

Able to work independently.

Able to manage distractions effectively.

Strong communication skills, both verbally and written.

Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.

Subsidized health plans, dental and vision coverage

401k retirement savings plan with company match

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers in major locations

Education Assistance

Service Recognition

National discounts to movies, theaters, zoos, theme parks and more.

What We Can Do for You:

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

What To Expect Next:

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Senior Claims Adjuster (Workers Compensation)

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