Claims Adjuster I

Salary: $45,300.00 - $77,000.00 Annually Location : Lexington County, SC Job Type: FTE - Full-Time Job Number: 187789 Agency: State Accident Fund Opening Date: 04/28/2026 Closing Date: 5/12/2026 11:59 PM Eastern Class Code:: AP03 Position Number:: 60025447 Normal Work Schedule:: Monday - Friday (8:30 - 5:00) Pay Grade: GEN08 Hiring Range - Min.: $45,300.00 Hiring Range - Max.: $54,699.00 Opening Date: 04/28/2026 EEO Statement: Equal Opportunity Employer Agency Specific Application Procedures:: ALL APPLICANTS MUST APPLY ONLINE at www.careers.sc.gov. Answer all application questions completely. Supplemental questions are considered part of your official application. Any misrepresentation will result in your disqualification from employment. Please complete the state application to include all current and previous work history, salary and education. A resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position.VETERAN APPLICANTS: Per SC §1-1-550 Veterans Preference: To claim Veteran's Preference, all eligible persons shall submit a DD Form214, Certificate of Release or Discharge from Active Duty at time of interview. Normal Work Schedule (Other):: Upon successfully completing twelve (12) months of employment with the agency, employees may be eligible for a hybrid telecommuting schedule. Veteran Preference Statement: South Carolina is making our Veterans a priority for employment in state agencies and institutions.Job ResponsibilitiesThe mission of the South Carolina State Accident Fund is to provide cost-effective, guaranteed workers' compensation insurance for state agencies and other governmental entities along with exceptional service to our state workers. Are you looking for new opportunities to further your career? Ever thought about a career in state government but weren't sure where to start? If so, look no further than the South Carolina State Accident Fund. We are seeking hardworking and dependable candidates just like you to apply!The South Carolina State Accident Fund (SAF) is the leading provider of workers' compensation insurance in South Carolina. Since 1943, the State Accident Fund has provided a continuous guaranteed source of cost-effective workers' compensation coverage. Today we serve nearly 600 employers and 200,000 state and local government employees throughout the state. Within the State Accident Fund, the Uninsured Employers Fund (UEF) administers benefits as determined by the SC Workers' Compensation Commission for employers who fail to secure proper workers' compensation coverage for their businesses. The Claims Adjuster I, acting as a member of the Edisto Claims Team with guidance from the Edisto Claims Team Manager (CM), willProvide workers' compensation benefits to injured workers and assist injured workers, policyholders, medical providers, attorney's and other stakeholders. Record all accepted or denied body parts, lost time and/or return to work dates. Determine compensability of claims and monitor all lost time periods substantiated by reviewing medical documentation and authorizes income replacement. Authorize and submit medical payments and lost time payments in accordance with the SC Workers' Compensation LawFile all workers' compensation forms timely and accurately in accordance with the SC Workers' Compensation Law. Monitor all claims in accordance with agency policy and procedures as outlined in the Claims Training Manual. Perform monthly claims reviews and a plans of action for all assigned claims and attend Claims Review Team meetings. Recommend vocational rehabilitation or special medical management referrals. Attend depositions, mediations, hearings, clincher conferences and informal conferences before the Workers' Compensation CommissionReview cases with the CM and obtain authority for settlements following recommendations from the policyholder. Negotiate settlements with claimant or attorney and prepare all necessary settlement documents/forms with CM oversight. Review and monitor all reserves throughout the duration of claims. With the assistance of internal legal counsel and the CM, read and review Workers' Compensation Commission orders. Handle special projects and perform other duties as may be required and/or assigned. THIS POSITION MAY REQUIRE OCCASIONAL IN-STATE TRAVEL.Minimum and Additional RequirementsA Bachelor's Degree. Applicants not meeting the State's minimum requirements are encouraged to apply and may be considered pending approval of an acceptable equivalent combination of education and experience in accordance with State Human Resources Regulations. Must possess or be able to obtain a valid South Carolina Insurance Adjuster's License within twelve (12) months of the start of employment.Preferred QualificationsExperience and/or knowledge in customer service, data entry, paralegal services, medical terminology, medical billing and/or coding, responding to telephone and email inquiries, and/or working with confidential information. Experience and/or knowledge handling/adjusting/examining workers' compensation claims or insurance claims. Experience and/or knowledge of workers' compensation laws, rules and regulations, insurance practices and procedures, medical terminology, costs of medical treatment, and/or methods and techniques for determining compensable wages. Experience and/or knowledge of office practices, policies, procedures, rules, regulations and equipment. Ability to establish and maintain effective working relationships and work independently as well as a member of a team as needed. Possesses the ability to communicate effectively both orally and in writing. Additional CommentsThe State Accident Fund is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth, or related medical conditions including, but not limited to, lactation), national origin, age (40 or older), disability or genetic information.DISCOVER YOUR WORKLIFE BALANCE!The State Accident Fund offers an exceptional benefits package for full-time (FTE) employees: Health, dental, vision, long-term disability, and life insurance for employees, the employee's spouse, and children; 15 daysof annual (vacation) leave per year; 15 days of sick leave per year; 13 paid holidaysEmployee Assistance ProgramUp to 5 counseling sessions annually for employees and eligible household members, Up to 5 Life Management Services (i.e., legal, financial, child/elder/pet care), and Unlimited assessment and referral services; Paid Parental LeaveState Retirement Plan and Deferred Compensation ProgramsHybrid telecommuting schedules**; and Public Service Loan Forgiveness*Employees in FTE status earn additional annual leave the longer they remain employed with the state. **Eligibility to work remotely requires successfully completing a period of employment with the agency. A copy of your transcript may be uploaded as an attachment to the application. Upon hiring, candidates must submit official college transcript(s) or diploma(s) for degree(s) obtained. Failure to produce an official, certified transcript may result in not being hired or termination. Benefits for State EmployeesThe state of South Carolina offers eligible employees generous benefits, including health and dental insurance; retirement and savings plan options; and paid vacation and sick leave. Plus, work-life balance programs such as telecommuting and flexible work schedules are available to employees of some state agencies.Insurance BenefitsEligible employees may enroll in health insurance, which includes prescription coverage and wellness benefits. Other available insurance benefits include dental, vision, term life insurance, long term disability and flexible spending accounts for health and child care expenses.Retirement BenefitsState employees are also offered retirement plan options, including defined benefit and defined contribution plans. Additionally, eligible employees may elect to participate in the South Carolina Deferred Compensation Program, which is a voluntary, supplemental retirement savings plan offering 401(k) and 457 plan options.Workplace BenefitsState employees may also be eligible for other benefits, including tuition assistance; holiday, annual and sick leave; and discounts on purchases, travel and more.Note: The benefits above are available to most state employees, with the exception of those in temporary positions. Employees in temporary grant and time-limited positions may be eligible for all, some or none of these benefits as benefits are associated with each position type. For these positions, contact the hiring agency to determine what benefits may be available. 01 Supplemental questions are considered part of my official application. Any misrepresentation will result in my disqualification from employment. I have completed the state application to include ALL current and previous work history and education. I understand that a résumé will not be accepted or reviewed to determine if I have met the qualifications for the position. I have read and acknowledge the above statement. YesNo02 Which of the following best describes your highest level of education? High School Diploma or EquivalentAssociates DegreeBachelor's DegreeMaster's Degree or Higher03 This position requires you to possess a valid South Carolina Adjusters License. Do you currently possess a valid South Carolina Adjusters License, OR do you have the ability to obtain one within twelve (12) months from the start of employment? YesNo04 How many years of experience do you have in handling/adjusting workers' compensation claims or other insurance claims? No ExperienceLess than 1 Year1-3 Years3-5 Years5+ Years05 How many years of experience/knowledge do you have related to workers' compensation laws, rules and regulations, insurance practices and procedures, medical terminology, costs of medical treatment, and/or methods and techniques for determining compensable wages? No ExperienceLess than 1 Year1-3 Years3-5 Years5+ Years06 This is a South Carolina Pay Grade GEN08 position. If offered the position, are you willing to accept a salary offer between $45,300.00 and $54,699.00? YesNo07 This position is in Lexington, SC. If selected, I understand that I must successfully complete a period of employment with the agency before becoming eligible to work a hybrid telecommuting schedule. I understand that prior to that, I would be required to work in the office located in Lexington, SC. YesNo08 How did you learn about this career opportunity? Careers.sc.govLinkedIn.comCurrent or Former EmployeeOther09 If you learned of this opportunity from a current or former employee or "other" source, please specify the employee's name or other source. If this does not apply, type "N/A". Required Question