Review Vacancy
Date Posted: 04/13/16
Applications Due: 04/28/16
Vacancy ID: 29214
Position Information
NY HELPNo
AgencyInsurance Fund, State
TitleClaims Services Representative 1
Occupational CategoryOther Professional Careers
Salary Grade18
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $52293 to $66494 Annually
Employment Type Full-Time
Appointment Type Permanent
Jurisdictional Class Competitive Class
Travel Percentage 10%
Schedule
Workweek Mon-Fri
Hours Per Week 37.5
Workday
From 8:30 AM
To 5 PM
Flextime allowed? No
Mandatory overtime? No
Compressed workweek allowed? No
Telecommuting allowed? No
Location
County Albany
Street Address One Watervliet Avenue Extension
City Albany
StateNY
Zip Code12206
Job Specifics
Minimum Qualifications YOU MUST BE A CURRENT STATE EMPLOYEE TO BE ELIGIBLE FOR APPOINTMENT TO THIS POSITION.
Claims Services Representative 1 Grade 18: Eligible for transfer under Section 70.1 of the Civil Service Law, having one year of permanent competitive service in an appropriate title. Appropriate titles include but are not limited to:
Compensation Claims Investigator SG-18, Policyholder Services Representative 1 SG-18, Underwriter 1.
Duties Description under the general supervision of a Claims Services Representative 2, oversees all aspects of workers compensation and disability benefits claims processing from inception to closing; initially determines the compensability of claims and files appropriate documentation with the Workers Compensation Board (WCB); calculates and adjusts reserves consistent with case analysis over the anticipated life of the claim; recommends cases for appeal to WCB; negotiates and/or makes recommendations regarding lump sum settlements; issues payments and requests for reimbursement where claims for supplemental benefits are involved; reviews awards to ensure the correct recipient and rate of compensation; schedules or waives medical examinations as necessary; analyzes medical bills to determine causality, levels of treatment, necessity for treatment, appropriateness of fees and procedure codes, and apportionment status; responds to requests for home modifications, home health care personnel, medication, and medical supplies and appliances; negotiates billing adjustments with medical care providers and suppliers applying workers compensation fee schedules and rules; identifies and initiates referrals to the Legal Department; and reviews case activity and determines when a claim can be retired.
Additional Comments YOU MUST BE A CURRENT STATE EMPLOYEE TO BE ELIGIBLE FOR APPOINTMENT TO THIS POSITION.
Some positions may require additional credentials or a background check to verify your identity.
Contact Information
Name Louis LaMay
Telephone
Fax (518) 437-1618
Email Address hr@nysif.com
Address
Street 15 Computer Drive West
City Albany
State NY
Zip Code 12205
Notes on ApplyingPlease include the position title and vacancy id number on your cover letter. Candidates should mail a resume and cover letter to 15 Computer Drive West, Albany, NY 12205 or fax to 518-437-1618. Resumes may also be e-mailed to hr@nysif.com.
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