Medical Claims Review Manager jobs in Sumter, SC

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.