Review Vacancy
Date Posted: 06/13/18
Applications Due: 06/23/18
Vacancy ID: 54217
Position Information
AgencyWorkers' Compensation Board
TitleMedical Care Representative, WCB Item #4271
Occupational CategoryHealth Care, Human/Social Services
Salary Grade19
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $59671 to $75785 Annually
Employment Type Part-Time
Appointment Type Permanent
Jurisdictional Class Competitive Class
Travel Percentage 0%
Schedule
Workweek Mon-Fri
Hours Per Week 37.5
Workday
From 9 AM
To 5 PM
Flextime allowed? No
Mandatory overtime? No
Compressed workweek allowed? No
Telecommuting allowed? No
Location
County Albany
Street Address Medical Director's Office, Medical Guidelines Unit
150 Broadway
City Menands
StateNY
Zip Code12204
Job Specifics
Minimum Qualifications Candidates must be reachable on the appropriate Civil Service list. Only permanent Medical Care Representatives are eligible for transfer.
Duties Description Under the direct supervision of the Supervising Medical Care Representative, SG-23, the Medical Care Representative, SG-19, will be responsible for the medical review and preparation of files for disputed medical bill resolution via the WCB arbitration process. The incumbent must be knowledgeable of NYS Workers’ Compensation law, rules and regulations and appropriately represent the Workers’ Compensation Board while interacting with healthcare providers, carriers, and arbitrators. Specific duties of the Medical Care Representative include, but are not limited to: Following review of the HP-1 arbitration request by the SG-14 WC Examiner and final approval by SG-18 Senior WC Examiner, perform a comprehensive medical review of billing/reporting codes and supporting documentation to ensure that the services billed are appropriate for the services rendered; reviewing the arbitration request, associated bills and documentation to ensure the applicable fee schedule amount in dispute is based on the correct interpretation of the Workers’ Compensation Board Fee Schedules and associated Ground Rules and Regulations; preparing a written summary of all issues in the dispute; representing the Workers’ Compensation Board at desk and panel arbitration hearings; and promoting communication between providers and payers to resolve disputes outside of the arbitration process by explaining WC Law, fee schedules and applicable Ground Rules.
Additional Comments Qualified candidates should send a letter of interest and resume which lists your actual Civil Service title, salary grade and specific verifiable information as to how you meet the minimum qualifications to be eligible to apply for this position. Please send your application to HRM@WCB.ny.gov (email applications are preferred). It is important that you reference the WCB Item #4271 in the subject line of your email to ensure receipt of your application. (Please do not reference the Vacancy ID No.)
Some positions may require additional credentials or a background check to verify your identity.
Contact Information
Name Recruitment Unit
Telephone 518-474-2685
Fax 518-486-6364
Email Address HRM@WCB.NY.GOV
Address
Street Human Resources Management
328 State Street
City Schenectady
State NY
Zip Code 12305
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