INSURANCE AND CLAIMS ANALYST -Workers Compensation -RE-POST

Salary : $48,198.85 - $53,018.74 Annually

Location : SC, SC

Job Type : FULL-TIME

Job Number : 02066

Department : RISK MANAGEMENT AND SAFETY

Opening Date : 02 / 07 / 2025

Closing Date : 3 / 28 / 2025 5 : 00 PM Eastern

Description

The purpose of the class is to coordinate and administer the County's workers' compensation, tort, property, liability, and casualty claims; perform a variety of advanced and complex clerical work in the preparation and maintenance of department records; to perform clerical tasks as assigned; and to provide professional and courteous customer service always. The class is given a general outline of work to be performed and is free to develop work methods and sequences; work is reviewed periodically by the supervisor.

This announcement may close prior to posted closing date.

Duties

ESSENTIAL JOB FUNCTIONS

• Manages day-to-day claims operations, including claims evaluation, adjudication, and customer service in accordance with agreed quality and production standards.
• Processes claims in a timely manner and complies with industry fair claims practices and applicable state regulations concerning the processing of claims.
• Coordinates and facilitates the management of workers compensation claims for Dorchester County), including assessing, investigating, reviewing, negotiating, and determining workers compensation claims, weekly and provisional liability entitlements, coordinating medical treatment and indemnity payments in accordance with SC's laws and regulations.
• Manages, and processes insurance claims and information for external insurance companies, including worker's compensation, tort, property, liability, crime, and cyber insurance.
• Maintains insurance on all County owned property, buildings, building contents, fleet vehicles; and evaluates appraisals of property for coverage level endorsements; prepares necessary insurance budget requirements and cost allocations.
• Provides settlement recommendations for review and approval by the Director RMS; resolves moderately complex issues regarding claims operations; and maintains all claims related documentation.
• Assists in the development, implementation, evaluation, review, and improvement of the County's claims management / administration policies, procedures, and processes.
• Serves as liaison among the Dorchester County, insurance carriers, third party administrators, nurse case managers and attorneys; obtains and furnishes information to answer questions from carriers and coordinates meetings; attend various meetings, mediations, hearings and informal conferences regarding related issues; processes, generates and verifies all workers compensation forms including First Report of Injury (WCC Form 12 A) and Statement of Earnings (Form 20); handles payments for claims, and assist with Workers' Compensation audit procedures and completion.
• Manages department's purchasing-related activities including but not limited to, processing requisitions, purchase orders, invoices.
• Attends trainings, meetings, seminars and / or workshops to enhance job knowledge and skills.
• Attends staff, committee, and county meetings as required.
• Assists the Director in complying with and analyzing property and casualty claims and loss information to identify trends, risk exposures and hazards; assists in the preparation and distribution of loss reports and recommendations to County officials, department heads and supervisors to reduce liability; implement loss prevention programs and assist in the analysis of the causation of specific department losses.
• Handles claim files (uploads documents, files paperwork, locates / requests missing / revised documents and distributes information as needed).
• Coordinates with claims adjusters and TPAs for automobile and general liability claims. Follow-up on repair estimates needed for insurance claims.
• Processes claims file correspondence to the appropriate claim files. Proficient in relabeling documents; working within department's network folders.
• Processes insurance premiums and renewals; allocates funds from the correct departments; and handles additions / deletions of County assets to insurance policies. Manages the accounting associated with insurance credits. Assists in the annual renewal process for properly insuring County assets.
• Maintains documentation for federal programs such as Occupational Safety and Health Administration (OSHA); maintains OSHA 300 logs and statistics; and prepares annual reports.
• May prepare and / or process quarterly random drug testing reports per Dorchester County's Drug and Alcohol Policy.
• Prepares complex and confidential correspondence, memoranda, reports, etc.
• May assist the department in the preparation of training classes; prepare fliers, handouts, or other materials to conduct and promote training classes; and maintain records on training program attendance.
• May assist in departmental budgeting and financials, reconciliation of accounts and monitoring of grants.
• Operates a personal computer and appropriate software packages or its equivalent pertaining to departmental activities.
• Receives, reviews, prepares, and enters data into various applications, databases, and / or Excel spreadsheets. Logs in claims updates in claims database, created and maintains claims files, and generates claims reports.
• Prepares monthly and ad-hoc reports as required.
• Carries out special projects, serves on various committees a needed, and performs assignments as directed by Department Head or designee.
• Serves as department's timekeeper.
• May share on-call duties with other staff members.
• Performs other related job duties as assigned.
• Develops data analysis reports for the department; performs analysis on weekly and monthly basis; makes policy and operational recommendations to Department Head based on statistical analysis. Assists in preparing complex reports and metrics.
• Provide input and assistance in identifying, establishing, and maintaining internal operating procedures.

Qualifications

Education and Experience :

High school diploma or GED supplemented by education or experience in a closely related field.

Requires at least five (5) years of related work experience. Application must outline experience and knowledge of workers compensation claims and management.

Special Qualifications :

Intermediate computer skills to include Word, Excel, PowerPoint, Outlook and other productive platforms.

Must have and maintain a valid South Carolina driver's license with a safe driving record.

Excellent customer service, verbal and written communication skills.

For more information on Dorchester County Government please view the information below :

Benefits for County Employees

County Employees may be eligible for a variety of State benefits associated with their employment. From a comprehensive health and dental insurance program, to generous annual and sick leave policies, to a solid and secure retirement system.

Healthcare Benefits

Full-time employees)

Dorchester County is a part of the State Benefits Program. The State program offers its employees a comprehensive health and dental program, along with a wide array of supplemental insurance programs. South Carolina has long been committed to providing its employees the best possible insurance benefits at the greatest possible value. We've maintained that commitment, too, even in the face of healthcare costs that continue to soar. You may refer to the link for more information.

Retirement Benefits

In addition to our health and dental insurance programs, all county employees are a part of the South Carolina Retirement System. These programs are designed to help provide county employees secure retirement alternatives that will best meet their needs. You may refer to the link for more information.

Workplace Benefits

In addition, county employees may be eligible for other benefits, such as holidays, annual leave, and sick leave.

Note : The above benefits are available to most county 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 based on the benefits associated with each position. For these positions, please contact the hiring agency to determine what benefits may be available for the particular position.

Do you possess a high school diploma or GED supplemented by education or experience in a closely related field of the position.

Do you possess 5 years of related work experience?Experience must include processing and supporting workers compensation claims and investigations.

If yes to the above question, describe your experience and where you gained this experience.

Do you have a valid South Carolina driver's license?

This position requires a 5-year safe driving record. Are you able to meet this requirement?

How do you rate your computer skills? 1 being low, 10 being excellent.

Describe your experience using Microsoft products software - Word, Excel, and PowerPoint and other platforms.

You must be able to deal with difficult customers in a professional manner. Do you feel that you possess these traits?

Do you have experience managing a workers compensation claim program?

If yes to the above question, describe your experience and where you gained this experience.

Required Question

Salary : $48,199 - $53,019