What are the responsibilities and job description for the Insurance Analyst I position at State of South Carolina?
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Repost of Job 17021. Prior applicants are still being considered and need not reapply.
Join the South Carolina state government, where you can have a meaningful career, incomparable benefits, and a positive work-life balance! The Workers' Compensation Commission's mission is to provide an equitable and timely system of benefits to injured workers and employers in the most responsive, accurate, and reliable manner possible.
The WCC is looking for an eager person to fill an entry-level position. You will learn and gain experience in SC state government and workers' compensation. The South Carolina Workers’ Compensation Commission seeks a motivated, dedicated, and detail-oriented Insurance Analyst. This role involves analyzing and researching incoming claims to verify insurance coverage, creating files, assessing fines, and responding to stakeholder inquiries. - Researching, verifying, and providing workers' compensation coverage information for claims filed without insurance coverage (“no report” files).
- Assigning "no report" files to compliance officers for investigation. Create and establish claim files for claims of insurance coverage.
- Verify coverage for additional parties added by Motion, Orders, and Amended Forms 50/52, etc.
- Generate Commission fines and answer incoming calls. Research and respond to inquiries from the public, staff, claimants, attorneys, healthcare providers, employee coverage issues, fines, and claim file status.
- Monitor electronic insurance reporting submissions and troubleshoot issues by responding to stakeholder inquiries regarding duplicate claims and rejected submissions. Collaborate with IT to resolve more technical program issues.
- Other tasks as assigned, such as but not limited to distributing inter-office mail. Processing e-case registrations and data entry.
A high school diploma and work experience that is directly related to processing workers' compensation insurance claims. A bachelor’s degree may be substituted for the related work experience.
Knowledge Skills and Abilities:
- Strong analytical skills.
- Proven ability to work in a high-volume environment with attention to detail.
- Experience with electronic data Interchange (EDI) is desired but not required.
- Familiarity with workers’ compensation laws, regulations, policies, procedures, and organizational functions.
- Knowledge of applicable terminology and research practices.
- Ability to deal courteously and effectively with the public.
- Ability to communicate effectively.
- Strong organizational and time management skills.
- Microsoft Office proficient. Familiarity with document claims management software such as OnBase and claims management software such as Progress is preferred.
The Workers' Compensation Commission offers an exceptional benefits package for FTE positions that includes:
- Health, Dental, Vision, Long Term Disability, and Life Insurance for Employees, Spouses, and Children.
- 15 days of annual (vacation) leave per year
- 15 days of sick leave per year
- 13 paid holidays
- State Retirement Plan and Deferred Compensation Programs
- Occasional overnight travel and overtime may be required.
- Other duties as assigned.
Salary : $32,686 - $60,471
