Senior Claims Adjuster – Workers Compensation

BlueCross BlueShield of South Carolina

Claims Adjuster for investigating and negotiating resolutions to worker's compensation claims at BlueCross BlueShield. Leveraging expertise to manage complex caseloads and provide effective claim outcome recommendations.

Posted 6/11/2026full-timeColumbia • South Carolina • 🇺🇸 United StatesSeniorWebsite

About the role

Key responsibilities & impact

Independently investigates, evaluates, and negotiates the resolution of assigned claims
Conduct investigations of assigned claims in adherence with corporate timeliness and quality performance standards
Manage caseload to ensure proactive disability, medical management and timely response to treatment recommendations
Document activities, case action plans, settlements evaluations and requests for authorizations in the claim notes
Provide management and internal and external customers with documentation to support recommendations and claim status
Direct litigation process and work with attorneys to establish defense strategy and case legal budget
Negotiate settlements directly with claimants or opposing counsel.
Evaluate specials, damages, and/or extent of disability and negotiate settlements with individuals and/or attorneys.

Requirements

What you’ll need

Bachelor's degree (or equivalent experience)
4 years of area related adjusting experience
Ability to analyze laws, regulations and contract language
Ability to evaluate issues and develop recommendations
Ability to handle confidential and sensitive information
Ability to investigate assigned claims and propose claims adjustments
Strong verbal and written communication skills.
Strong interpersonal skills.
Valid adjuster's license in required states or ability to acquire within 6 months if required by resident state's department of insurance.

Benefits

Comp & perks

Subsidized health plans
Dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies, theaters, zoos, theme parks and more.

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

claims investigationclaims negotiationcase managementsettlement evaluationlitigation processlegal budget managementdisability evaluationmedical managementdocumentation managementcontract analysis

Soft Skills

analytical skillsrecommendation developmentconfidentiality handlingverbal communicationwritten communicationinterpersonal skills

Certifications

Bachelor's degreeadjuster's license