Join the South Carolina state government and contribute to the Workers' Compensation Commission's mission of providing an equitable and timely system of benefits to injured workers and employers.
This entry-level role focuses on analyzing and researching incoming claims to verify insurance coverage, creating claim files, assessing fines, and responding to stakeholder inquiries. You will work with workers' compensation coverage information, monitor electronic insurance reporting submissions, and help troubleshoot issues related to duplicate claims and rejected submissions.
The position also supports medical services policy functions, including medical bill review, maintaining compliance with the MSD Bill Review software vendor, and ensuring bill review accuracy for hospital and ambulatory payment manuals in connection with formal bill disputes and TPA bill reviewer audits.
High school diploma and work experience directly related to processing workers' compensation insurance claims.
Experience with medical billing and/or coding.
A bachelor's degree may be substituted for related work experience.
Strong analytical skills.
Ability to work in a high-volume environment with attention to detail.
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.
Strong communication, organizational, and time management skills.
Proficiency in Microsoft Office.
Preferred qualifications:
- Certification or related experience in medical billing and/or coding
- Experience with CMS policies and the prospective payment system
- Bachelor's degree may substitute for related work experience
Health, dental, vision, long-term disability, and life insurance for employee, spouse, and children.
15 days of annual leave per year.
15 days of sick leave per year.
13 paid holidays.
State retirement plan and deferred compensation programs.
Location
South Carolina, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
1 month ago