Claims Examiner Supervisor - PN- Cincinnati
Claims Examiner Supervisor - PN- Cincinnati
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
What Youll Do:
Under general direction of the Administrative Officer 2 (AO2) or Program Administrator 2 or 3 (PA2/PA3):
- Supervises & directs (assigns & monitors) all work activities for the district / regional office staff customer service word processing claims examining (all 1st & 2nd level hearing issues) & docketing
- Supervises lower level supervisors (customer service & program administrator 1)
- Interprets & applies existing workers compensation laws IC / BWC rules policies & procedures & instructs personnel accordingly
- Follows up verbal instruction with written direction to ensure understanding & compliance
- Assists staff with the resolution of complex work activities
- Makes recommendations to AO2 PA2 PA3 or Regional Manager regarding policy & procedure changes to assure the efficient processing of claims
- Reviews & analyzes all queues in Case Manager Applications (Action items Action uploads Power BI VSSR etc.) & Outlook email (ODI / ODIPT File Drop etc.) to ensure inventories are current
- Works with other claims examiner supervisors to resolve claim word processing docketing & report issues (open pcn reports CAS tracking issues etc.)
- Updates information on CAS ECM & Case Manager as needed. Prepares or routes claims for exparte orders
- Maintains the risk & representative master files
- Serves as liaison with central office departments (administration fiscal information technology operations support security services customer service (interpreters) medical services human resources management planning & claims support) & the BWC
- Oversees & resolves all building operational issues: security maintenance issues etc. & reports concerns as needed
- Backs up other district office supervisors or regional program administrators as needed
See the attachedposition descriptionfor more details regarding this position.
At the State of Ohio we take care of the team that cares for Ohioans. We provide a variety of quality competitive benefits to eligible full-time and part-time employees*. For a list of all the State of Ohio Benefits visit ourTotal Rewards website! Our benefits package includes:
- Medical Coverage
- Free Dental Vision and Basic Life Insurance premiums after completion of eligibility period
- Paid time off including vacation personal sick leave and 11 paid holidays per year
- Childbirth Adoption and Foster Care leave
- Education and Development Opportunities (Employee Development Funds Public Service Loan Forgiveness and more)
- Public Retirement Systems (such as OPERS STRS SERS and HPRS)&Optional Deferred Compensation (Ohio Deferred Compensation)
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.
- This position is filled through an assessment consisting of a structured interview. The interview will be administered in person at the Cincinnati Regional Office.
- Unless required by legislation or union contract external candidates can expect starting salary to be set at the lowest rate of the salary range with gradual increases during and/or after completing probation and following successful annual performance review periods for applicable positions.
- This position may require travel; therefore the person occupying this position must be able to provide his/her own transportation &/or legally operate a state-owned vehicle.
- Compensation statement: The hourly wage for this position is not negotiable. For applicants who are not current State of Ohio employees the starting wage will be the hourly rate listed on this posting. Successful employees will move up a step in the salary range within one year and in most cases within four to six months with subsequent step increases occurring annually.
- ADA Statement: The Industrial Commission is committed to providing access and inclusion and reasonable accommodation in its services activities programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. To request a reasonable accommodation due to a disability please contact the ADA Coordinator at (voice) or by email to: as-soon-as possible but at least 14 days prior to the scheduled event.
- Background Check Information Statement: The final candidate selected for the position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicants prior criminal convictions will be made before excluding an applicant from consideration.
3 yrs. trg. or 3 yrs. exp. in workers compensation claims processing operation 6 mos. of which had to have been as supervisor or lead worker.
-Or in District Offices 3 yrs exp. as Claims Examiner 2 16792 or 30 mos. as Claims Examiner 3 16793.
-Or equivalent of Minimum Class Qualifications for Employment noted above.
Job Skills: Claims Examination
Technical Skills: Claims Examination Management Customer Service Training Communications
Professional Skills: Attention to Detail Developing Others Critical Thinking Problem Solving Time Management
Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services activities programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.
The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39) and as outlined in the posting.
Our mission is to serve injured workers and Ohio employers through expeditious and impartial resolution of issues arising from workers compensation claims and through the establishment of adjudication policy.
The Ohio Industrial Commission (OIC) Cincinnati Office is seeking a seasoned claims examiner with innate leadership and communication skills as well as in-depth and nuanced knowledge of all first and second level hearing issues including specifically in the areas of PTD and VSSR processing. A successful candidate must be able to work well independently. An accessible communication style and infinite patience are a plus.
Required Experience:
Manager
Employment Type
Full-Time
