Class Code:
AD43
General Nature of Work

Examines claims covered by the South Carolina Workers' Compensation Law.

Guidelines for Class Use/Distinguishing Characteristics

This is a journey-level class with responsibility for investigation, negotiation and settlement of assigned claims; or for review and authorization of payment on routine claims; or for the rehabilitation counseling of claimants to determine capacity to work.

Examples of Work

Obtains data from claimants, witnesses, employers, doctors and attorneys relative to claims covered under the Workers' Compensation Law.Negotiates settlements with claimants or claimants' representatives.Advises carriers and employers of their responsibilities in claims to insure proper handling.Checks state and county property to determine kind and amount of insurance required.Inspects insured property to determine if it meets safety regulations and other requirements.Reviews property losses to determine if reported losses are accurate.Audits claim files to determine if claim is properly completed and processes accordingly.Estimates the anticipated cost on all new claims.Determines which medical bills are eligible for payment and authorizes payment.Analyzes information and decides which claims should be forwarded to the investigative unit for review.Coordinates work of subordinate employees in processing of claims.Determines incurred losses from open files.Authorizes the closing of claims.Prepares reports and updates related records.Handle insurance renewals.Respond orally and in writing with insureds and prospective insureds.Process endorsements using information received from field agents, review and enter policy and rating information into data processing system.Process loss payables, certificates, mortgage clauses, etc.Process reinsurers safety recommendations.Electronically store all policies, correspondence, and memorandums used as permanent records of insurance.

Knowledge, Skills and Abilities

Knowledge of the South Carolina Workers' Compensation Law. Knowledge of state workers' compensation fee schedule and medical terminology. Knowledge of standard insurance practices, policies and procedures. Knowledge of property examinations as related to insurance safety standards. Ability to use discretion in negotiation of settlements with claimants. Ability to analyze and draw valid conclusions from documentary evidence. Ability to communicate effectively.

Minimum Requirements

A bachelor's degree and related experience.

Fed Category:
E2
Band:
04
Salary:
Minimum:
$32,686.00
Midpoint:
$46,578.00
Maximum:
$60,471.00
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