StateJobsNY

NY HELPNo

AgencyWorkers' Compensation Board

TitleMedical Care Representative, WCB item# 3359 (multiple items)

Occupational CategoryHealth Care, Human/Social Services

Salary Grade19

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $55126 to $70013 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

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

County Kings

Street Address Office of the Medical Director

111 Livingston Street

City Brooklyn

StateNY

Zip Code11201

Minimum Qualifications Candidates must be reachable on the appropriate Civil Service eligible list.

Please note: Only permanent Medical Care Representatives are eligible for transfer.

Duties Description Under the guidance of the Medical Director and Principal Medical Care Representative, SG-25, with direct supervision by the Supervising Medical Care Representative, SG-23, the Medical Care Representative, SG-19, is responsible for the medical review and preparation of files for disputed medical bill resolution via the Workers’ Compensation Board (WCB) arbitration process. The incumbent must be knowledgeable of New York State (NYS) Workers’ Compensation law, rules and regulations and appropriately represent the Workers’ Compensation Board while interacting with healthcare provides, carriers, and claimants. Specific duties include, but are not limited to the following: reviewing and performing a comprehensive medical review of billing/reporting codes and supporting documentation of HP-1 arbitration requests; reviewing arbitration requests, bills and documentation to ensure the applicable fee schedule amount in dispute is based on the correct interpretation of the Medical Fee Schedule; making recommendations to the Medical Director regarding the updating of Medical Treatment Guidelines based on inquires received from phone calls, emails and correspondence as well as the review of medical evidence and peer review articles; and assisting in the medical review, update and correct application of newly released and/or revised billing and reporting codes for the provider medical fee schedule, Emergency Room fee schedule, ambulatory surgery fee schedule and inpatient hospital fee schedule.

Additional Comments Please note: This posting is for multiple items.

This location receives a downstate location pay adjustment of $3026, in addition to the yearly salary.

Some positions may require additional credentials or a background check to verify your identity.

Name Cassandra Cade

Telephone

Fax 518/486-6364

Email Address HRM@WCB.ny.gov

Address

Street Human Resources Office - Room 228

328 State Street

City Schenectady

State NY

Zip Code 12305

Notes on ApplyingQualified 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 Items # 3359 in the subject line of your email to ensure receipt of your application. (Please do not reference the Vacancy ID No.)

Please note: This posting is for multiple items.
This location receives a downstate location pay adjustment of $3026, in addition to the yearly salary.