What are the responsibilities and job description for the Workers' Comp Claims Adjuster position at Lexington Medical Center?
Insurance Services
Full Time
Day Shift
Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the Best Places to Work in South Carolina and the first hospital in the state to achieve Magnet with Distinction status for excellence in nursing care.
The 607-bed teaching hospital anchors a health care network that includes six community medical centers and employs more than 8,700 health care professionals. The network includes a cardiovascular program recognized by the American College of Cardiology as South Carolina's first HeartCARE CenterTM and an accredited Cancer Center of Excellence affiliated with MUSC Hollings Cancer Center for research and education. The network also features an occupational health center, the largest skilled nursing facility in the Carolinas, an Alzheimer's care center and nearly 80 physician practices. Its postgraduate medical education programs include family medicine and transitional year.
Job Summary
Assist management in Insurance Services with all aspects of the daily administration of the self-insured Workers' Compensation program. Must be able to take appropriate measures to ensure compliance with timely bill payment, restrictions, and days away entry and OSHA reporting. Works with medical providers to ensure timely scheduling and proper treatment of all workers' compensation claims. Interfaces with those involved with the claim (i.e. manager, injured employee, medical provider, TPA adjuster, safety) as needed.
Monitors activities ensuring efficiency in accordance with applicable laws and regulations. Maintains a thorough knowledge of Federal, State and Local law pertaining to areas of responsibility. Completes all reporting relating to workers' compensation and OSHA notification requirements, as needed.
Minimum Qualifications
Minimum Education : Bachelor's Degree from an accredited college or university with major course in public administration, risk management, workers' compensation or closely related field.
Minimum Years of Experience : 5 years of increasingly responsible professional and administrative experience in Workers' Compensation.
Substitutable Education & Experience (Optional) : A Bachelor's Degree may be offset with paralegal certificate and 5 years of additional commensurate experience in workers' compensation claims management.
Required Certifications / Licensure : None.
Required Training : Excellent interpersonal skills.
- Knowledge of business office operations and administrative clerical operations.
- Ability to communicate effectively both orally and in writing with employees and managers, to maintain confidentially in daily operations, to conduct daily duties in a professional appearance and manner.
- Advanced knowledge, ability, and working experience in Microsoft Word, Excel, and PowerPoint. Knowledge, ability, and experience in PeopleSoft is a plus.
- General knowledge of Insurance RMIS system is a plus.
- Basic knowledge of SC Workers' Compensation law, OSHA recording requirements, and claims management preferred.
- Must be able to use file systems and clearly communicate via telephone, in person and through written and electronic media.
Essential Functions
Duties & Responsibilities
We are committed to offering quality, cost-effective benefits choices for our employees and their families :
Equal Opportunity Employer
It is the policy of LMC to provide equal opportunity of employment for all individuals, and to remain compliant with applicable state and federal laws and regulations. LMC strives to provide a discrimination-free environment, and to recruit, select, on-board, and employ all employees without regard to race, color, religion, sex, age, disability, national origin, veteran status, or pregnancy, childbirth, or related medical conditions, including but not limited to, lactation. LMC endeavors to upgrade and promote employees from within the hospital where possible and consistent with the employee's desires and abilities and the hospital's needs.
