Claims Examiner, Sr. jobs in Sumter, SC

Claims Examiner, Sr. reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner, Sr. studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner, Sr. determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner, Sr. occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Claims Examiner, Sr. typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)

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Workers’ Compensation Claims Manager
  • Thompson Construction Group, Inc.
  • Sumter, SC FULL_TIME
  • Since its foundation in 1986, Thompson Construction Group, Inc. has grown from a small, local company into one of the largest privately held companies based in South Carolina. Our diverse services portfolio includes capital projects, power services, maintenance services, disaster recovery, hydro consulting and commercial construction. We believe in investing in our employees to help them reach their professional goals, as well as their personal goals. Thompson promotes a work environment that fosters learning, leadership, and development along with a safety culture that never waivers. Thompson is headquartered in Sumter, South Carolina with offices spanning the United States, primarily southeast and central United States.

    Position Description

    Thompson Construction is seeking a Workers Compensation Claims Manager. This position requires daily interaction with a variety of workers’ compensation stakeholders including but not limited to, injured workers, health care offices, plant & field management and our TPA claims adjusters. Candidates must possess strong interpersonal skills to establish/maintain cooperative relationships with the various workers’ compensation stakeholders with specific emphasis on prompt medical treatment and a robust return to work program.

    Job Responsibilities

    • Set up new claims as well as manage multiple claim files daily and in a timely & effective manner.
    • Accurately and completely document claim information including conversations and maintain a comprehensive electronic file of communications related to the claim.
    • Schedule daily tasks to follow up on claim-specific activities. Ensure tasks are kept current.
    • Report claims information and injury reports accurately and promptly to the appropriate insurance carrier.
    • Communicate with the claims adjuster, sharing information to ensure appropriate handling of each claim.
    • When necessary, contact the treating physician following the injured employee’s appointment to obtain diagnosis, work restrictions and treatment plan.
    • When necessary, contact the injured employee and build a relationship. Maintain contact with the injured employee and respond to any questions or concerns regarding their recovery or any other questions they may have.
    • Act as liaison between all parties to ensure claims keep moving and employees get the proper treatment required to return to their pre-injury state.
    • Participate in all injury/incident calls.
    • Assist in development of Corporate and Division Standard Operating Procedures, policies and procedures for safety.
    • Other duties as assigned.

    Job Qualifications

    • Associate’s degree or equivalent education and/or work experience.
    • Computer skills in Microsoft Office-Office, Excel, and PowerPoint are required.
    • Previous experience with Workers Compensation or General claims handling
    • Knowledge of FMLA and ADA as pertains to workers’ compensation claims
    • Must be able to read, write and communicate clearly with supervisor/co-workers and understand.
    • Candidate may be required to pass a drug test and criminal background check based on job location/requirements.

    Benefits

    • We strive to provide a competitive compensation and benefits package. This includes but is not limited to medical, dental, vision, life insurance, 401(k), wellness programs and career development.

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • 20 Days Ago

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Field Claims Adjuster - Auto Damage
  • Progressive Insurance
  • Sumter, SC FULL_TIME
  • Join Forbes’ 2023 Best Employer for Diversity! As an auto damage claims adjuster, you’ll serve as Progressive’s point of contact with customers – directing and making decisions regarding the repair pr...
  • 29 Days Ago

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Independent Insurance Claims Adjuster in Manning, South Carolina
  • MileHigh Adjusters Houston Inc
  • Manning, SC FULL_TIME
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjus...
  • Just Posted

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Independent Insurance Claims Adjuster in Sumter, South Carolina
  • MileHigh Adjusters Houston Inc
  • Sumter, SC FULL_TIME
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjus...
  • Just Posted

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Sr. Manufacturing Engineer
  • Becton, Dickinson and Company
  • Sumter, SC FULL_TIME
  • Job DetailsJob Description SummaryJob DescriptionWe are the makers of possible BD is one of the largest global medical technology companies in the world. Advancing the world of health is our Purpose, ...
  • 2 Days Ago

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Sr. Business Analyst
  • SAFE FCU
  • Sumter, SC FULL_TIME
  • ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: • Development of business process models, business requirements/user stories (functional and non-functional) and maintenance of issues back...
  • 15 Days Ago

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0 Claims Examiner, Sr. jobs found in Sumter, SC area

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Nursing Assistant
  • Veterans Health Administration
  • Columbia, SC
  • Summary The Columbia, SC VAMC is seeking a qualified applicants to work as a Nursing Assistant at our facility. This is ...
  • 4/26/2024 12:00:00 AM

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Administrative Specialist II/ Titling and Licensing Specialist III - 164111
  • State of South Carolina
  • Blythewood, SC
  • Salary: $35,126.00 - $37,751.00 Annually Location : Greenville County, SC Job Type: FTE - Full-Time Job Number: 164111 A...
  • 4/26/2024 12:00:00 AM

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Claims Customer Service Advocate I
  • Spectraforce Technologies Inc
  • Columbia, SC
  • Title: Claims Customer Service Advocate I Location: Columbia, SC, 29229 Duration: 3 months assignment(Contract to hire) ...
  • 4/25/2024 12:00:00 AM

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PUBLIC AFFAIRS SPECIALIST
  • Air Combat Command
  • Shaw A F B, SC
  • Summary Click on "Learn more about this agency" button below to view Eligibilities being considered and other IMPORTANT ...
  • 4/25/2024 12:00:00 AM

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Interdisciplinary
  • Department of Defense
  • Columbia, SC
  • Summary About the Position: This is a Direct Hire Authority (DHA) solicitation utilizing the DHA for USACE Charleston Re...
  • 4/23/2024 12:00:00 AM

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Claims Customer Service Advocate I
  • Spectraforce Technologies Inc
  • Columbia, SC
  • Title: Claims Customer Service Advocate I Location: Columbia, SC, 29229 Duration: 3 months assignment(Contract to hire) ...
  • 4/23/2024 12:00:00 AM

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Internal Revenue Agent (Examiner-Joint Committee Specialist) 12 MONTH ROSTER 'AMENDED'
  • Department Of The Treasury
  • Columbia, SC
  • Duties WHAT IS THE LARGE BUSINESS & INTERNATIONAL (LB&I)DIVISION? A description of the business units can be found at: h...
  • 4/22/2024 12:00:00 AM

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Sr. Consumer Loan Specialist - Sales Customer Service
  • Republic Finance
  • Columbia, SC
  • Overview and Responsibilities: Are you looking for a long-term opportunity with a growing financial services company tha...
  • 4/22/2024 12:00:00 AM

Sumter /ˈsʌmtər/ is a city in and the county seat of Sumter County, South Carolina, United States. Known as the Sumter Metropolitan Statistical Area, the namesake county adjoins Clarendon and Lee to form the core of Sumter-Lee-Clarendon tricounty area of South Carolina that includes the three counties in the east central Piedmont. The population was 39,643 at the 2000 census, and it rose to 40,524 at the 2010 census. Known as the Gamecock City,[citation needed] Sumter lies near the geographic center of the state of South Carolina at 33°55′37″N 80°21′49″W / 33.92694°N 80.36361°W / 33.92694; ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner, Sr. jobs
$55,691 to $71,801
Sumter, South Carolina area prices
were up 1.5% from a year ago

Claims Examiner, Sr. in Riverside, CA
Health Claims Examiners, or Health Information Technicians, enter data electronically to process transactions.
December 14, 2019
Claims Examiner, Sr. in Evansville, IN
If you’re in dire straits, we can advise you on steps to get the OWCP claims examiner to pay attention to your needs, such as contacting the Department of Labor’s district director, or the national director via mail.
February 12, 2020
Claims Examiner, Sr. in Springfield, IL
No, the examiner is only involved in performing the exam and providing the results to the claims processor.
January 13, 2020