Job ID: 51645
Location: Greenville, South Carolina
Employment Type: Contract
Last Updated: 2 days ago
This is a remote position but candidate must reside in the Eastern US ideally SC, NC, or VA where their operations are.
Key Responsibilities
- Manage a designated caseload of workers’ compensation claims within established performance benchmarks and financial authority.
- Conduct thorough investigations to determine coverage, compensability, and liability while ensuring adherence to all legal and regulatory requirements.
- Track and complete all required statutory filings and deadlines in a timely manner.
- Evaluate claim details to develop strategies that drive favorable outcomes and reduce overall risk and costs to the organization.
- Identify potential fraud indicators and pursue subrogation opportunities when applicable.
- Oversee medical treatment plans, facilitate return to work efforts, and manage prescription authorizations in coordination with pharmacy benefit managers.
- Apply knowledge of employment laws—including FMLA and ADA—when coordinating claim activities.
- Partner with Safety teams to identify workplace risks and support initiatives that reduce future injuries.
- Build strong working relationships with internal stakeholders (HR, Legal, Operations, Brand teams) and external partners (attorneys, healthcare providers, vendors).
- Oversee a claims portfolio and serve as the primary contact for resolving claim-related questions or issues from associates, vendors, and brand partners.
- Research and address legal or procedural concerns related to ongoing claims and provide timely communication through phone, email, and digital platforms.
Qualifications
- Active adjuster license (state specific where required).
- Minimum of four years of workers’ compensation claims experience.
- Strong understanding of workers’ compensation laws, regulations, and claims procedures.
- Familiarity with medical terminology used in complex or long term claims.
- Proven negotiation and communication skills.
Compensation & Benefits:
- $35/hour
- FGP offers contract employees benefits including minimum essential coverage insurance, a fixed indemnity plan and a 401k retirement plan once eligibility requirements are met.
