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You will be updated with latest job alerts via emailThis position is responsible to audit incoming claims documents for compliance with applicable workers compensation claims management laws statutes and case laws.
This position may offer the ability to work remotely within Arizona based upon the departments business needs and continual meeting of expected performance measures.
The State of Arizona strives for a work culture that affords employees flexibility autonomy and trust. Across our many agencies boards and commissions many State employees participate in the States Remote Work Program and are able to work remotely in their homes in offices and in hoteling spaces. All work including remote work should be performed within Arizona unless an exception is properly authorized in advance.
Essential Duties and Responsibilities include but are not limited to:
This position will critically analyze submitted forms for compliance and issue appropriate awards when indicated.
Audit insurance carriers selfinsured employers and thirdparty administrators adjusting workers compensation claims.
Reviews all notices attached medical and/or documentation to verify it supports current change of status and/or calculation of wage and awards. After analysis specialist will issue correct corresponding award notification or document.
Answer incoming phone calls from injured workers attorneys interested parties claim adjusters medical providers and the general public.
Matches documents lacking information to existing Commission claims files by researching information in Claims database and for creating a new claim file for documents received when there is no existing claim file.
Provides backup assistance to data entry error resolution insurance or combine/delete as requested and
Participates in Arizona Management System (AMS) and daily Huddle board.
Attends staff meetings seminars conferences training classes.
Knowledge in
Basic knowledge or ability to learn of applicable workers compensation claims management laws statutes and case laws.
Basic Medical terminology.
Microsoft Office Suite; Outlook Word Excel Google Office Suite Gmail Sheets and Docs
Basic English
Basic Mathematics
The insurance industry claims adjusting standards and practices.
Skill in:
Communicating verbally and in writing to resolve disputes with interested parties.
Basic analysis of insurance medical and legal documents.
Reviewing and interpreting Arizona Workers Compensation laws rules procedures and court decisions
Critical thinking
Time Management
Initiative and attention to detail
Customer service
Organizing and planning
Basic Business process acumen management skills including workflows and information management.
Ability to:
Interpret medical records to determine physical limitations for injured workers.
Manage heavy workload with high level of accuracy and production.
Learn computer systems and applications.
Work well within a diverse and inclusive office environment.
Process documents in a timely manner and within established productivity standard.
Prioritizes work within established time frames.
Manage time effectively and meet deadlines.
Adapt to changing circumstances.
Demonstrate initiative and attention to detail.
Exercise discretion and judgment.
Works well under pressure.
Perform job responsibilities incorporating lean management and principles of the Arizona Management System.
Produce high quality nearly errorfree output.
The ideal candidate for this position will have:
Claims adjusting license certification (WCCA WCCP CPCU) or designation relating to workers compensation.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (EVerify).
The Arizona Department of Administration offers a comprehensive benefits package to include:
Sick leave
Vacation with 10 paid holidays per year
Health and dental insurance
Retirement plan
Life insurance and longterm disability insurance
Optional employee benefits include shortterm disability insurance deferred compensation plans and supplemental life insurance
By providing the option of a fulltime or parttime remote work schedule employees enjoy improved work/life balance report higher job satisfaction and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.
For a complete list of benefits provided by The State of Arizona please visit our benefits page
You will be eligible to participate in the state employee health/disability insurance plan and you are required to participate in the Arizona State Retirement System (ASRS). ASRS participation may begin immediately or upon your 27th week of employment. Contributions are matched by the employer.
If you have any questions please feel free to callor email for assistance.
Required Experience:
Unclear Seniority
Full-Time