Workers' Comp Claims Analyst — Remote Options

Doc PersonalBeratung GmbH; Columbia (SC); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

13 paid holidays

Retirement plan

Job summary

The South Carolina Workers’ Compensation Commission is hiring a claims analyst to research and verify coverage information for no report files, assign cases to compliance officers, and respond to public inquiries. The role supports medical billing review and ensures accurate bill dispute handling, with emphasis on compliance and customer service in a high-volume environment.

The position offers comprehensive state benefits and a stable government career path, with opportunities for professional

Qualifications

• High school diploma or related work experience in processing workers' compensation claims.
• Experience with medical billing and/or coding.
• 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.

Responsibilities

• 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 Motions, 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.
• Assists medical services policy analyst in the following areas: medical bill review; maintaining compliance with the MSD Bill Review software vendor; and ensuring accuracy in bill review for hospital and ambulatory payment manual for the purposes of formal bill disputes and TPA bill reviewer audits.

Skills

Analytical skills

Microsoft Office proficiency

Communication skills

Time management

Attention to detail

Education

High school diploma

Bachelor’s degree substitution allowed

Tools

Microsoft Office

Job description

The South Carolina Workers’ Compensation Commission is hiring a claims analyst to research and verify coverage information for no report files, assign cases to compliance officers, and respond to public inquiries. The role supports medical billing review and ensures accurate bill dispute handling, with emphasis on compliance and customer service in a high-volume environment.

The position offers comprehensive state benefits and a stable government career path, with opportunities for professional