State Workers Insurance Fund Claims Representative
State Workers Insurance Fund Claims Representative
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$ 44890 - 67678
1 Vacancy
Job Description
THE POSITION
Are you eager to start a new chapter in your career with the Commonwealth of Pennsylvania If so consider joiningthe Department of Labor & Industry State Workers Insurance Fund (SWIF) as a Claims Representative. This position gives you the opportunity to ensure compliance with applicable statute and claims administration practices while approving payment claims and identifying claim issues. If you are an analytically minded professional with a keen eye for detail we need you on our team!
DESCRIPTION OF WORK
As a Claims Representative you will be tasked with completing investigations for reported incidents and claims as well as processing acceptance or denial within an established timeframe. Work involves determining if preexisting conditions may impact a claim; identifying potential fraud; and making recommendations if excess use of physical therapy or medical equipment is identified. Effective communication is essential as you will have the opportunity to correspond with with claimants employers doctors hospitals and witnesses to determine eligibility for workers compensation benefits. You will also be responsible for monitoring claims creating factbased claims and accurately completing all required forms. Additional responsibilities include:
- Recommending use of Independent Medical Examinations (IME)
- Issuing ongoing indemnity payments
- Determining liability on all medical bills
- Processing claim payment related vouchers
Take your career up a notch with the SWIF Pittsburgh District Office!
Interested in learning more Additional details regarding this position can be found in the position description.Work Schedule and Additional Information:
- Fulltime employment
- Work hours are 8:00 AM to 4:00 PM Monday Friday with a 30minute lunch.
- Telework:You may have the opportunity to work from home (telework) parttime. In order to telework you must have a securely configured highspeed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework you will have the option to report to the headquarters office in Pittsburgh.
- Salary:In some cases the starting salary may be nonnegotiable.
- You will receive further communication regarding this position via email. Check your email including spam/junk folders for these notices.
REQUIRED EXPERIENCE TRAINING & ELIGIBILITY
QUALIFICATIONS
Minimum Experience and Training Requirements:
- Two years of clerical work experience that includes collecting recording compiling or preparing documents for medical health or workrelated insurance claims;or
- An equivalent combination of experience and training.
Additional Requirements:
- You must demonstrate the ability to adhere to the values and ethics of the Department of Labor and Industry.
- You must demonstrate the ability to work with professionalism discretion and good work ethic.
- You must have solid written and verbal communication skills.
- You must show initiative and problemsolving skills.
- You must be able to perform essential job functions.
How to Apply:
- Resumes cover letters and similar documents will notbe reviewed and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e. relevant detailed experience/education).
- If you are claiming education in your answers to the supplemental application questions you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
- Your application must be submitted by the posting closing date.Late applications and other required materials will not be accepted.
- Failure to comply with the above application requirements may eliminate you from consideration for this position.
Veterans:
- Pennsylvania law 51 Pa. C.S. 7103 provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans go towww.employment.pa/Additional%20Info/Pages/default.aspx and click the Veterans Preference tab or contact us at.
Telecommunications Relay Service (TRS):
- 711 (hearing and speech disabilities or other individuals).
If you are contacted for an interview and need accommodations due to a disability please discuss your request for accommodations with the interviewer in advance of your interview date.
The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit develop and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race color religious creed ancestry union membership age gender sexual orientation gender identity or expression national origin AIDS or HIV status disability or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
