Overview
CLAIMS REVIEWER I Jobs in Maryland, United States at State of Maryland
Title: CLAIMS REVIEWER I
Company: State of Maryland
Location: Maryland, United States
Introduction
Reimagine a career in public service. At WCC, we are collaborative and team oriented, innovative in our approach, and passionate about our work. We thrive on initiative, creativity and challenges to the status quo. Our employees are valued and empowered. We are proud of our achievements and consider excellence a continuous journey…not a destination end point. If you've got the right stuff and a passion for your work, come journey with us.
OUR MISSION
The Maryland Workers' Compensation Commission seeks to secure the equitable and timely administration of the provisions of the Maryland Workers' Compensation law on behalf of its customer, the injured workers and their employers, by providing an efficient forum for the resolution of individual claims.
OUR VISION
The Workers' Compensation Commission envisions a state wherein injured workers and employers are empowered to create an equitable partnership to facilitate prompt and fair resolution of workers' compensation matters.
About Us
Together we profoundly touch the lives of so many people and have enormous responsibility to the community by fulfilling our mission of securing equitable and timely administration of the law. The Commission continues to provide services to our constituent partners at a level rarely met throughout the United States. The professionalism, work ethic, and technological acumen manifest in our operations allows us to smoothly and effectively manage the challenges which invariably arise. Every division within the agency plays a vital role in keeping us in the forefront nationally…ARE YOU READY TO MAKE A MEANINGFUL DIFFERENCE IN YOUR COMMUNITY AND PURSUE YOUR CAREER PASSION WITH A NATIONALLY RECOGNIZED LEADER?
GRADE
09
This position is eligible for a non-competitive promotion to a Claims reviewer II (grade 10 -with growth to $66,759) after satisfactorily completing a training program and performing the full range of duties and responsibilities of the classification under general supervision.
LOCATION OF POSITION
10 East Baltimore Street, Baltimore, Maryland 21202
Main Purpose of Job
To review, analyze, investigate, and process Workers’ Compensation claims and related documents, and route action documents sent to claims queues to appropriate parties via the Comphub in an equitable and timely manner which also includes hearing related findings per the established rules & procedures of the Workers' Compensation law.
POSITION DUTIES
Responsible for reviewing and processing claim related documents received in the claims queues including wages statements and enter/strike appearances via CompHub in accordance with the established procedures. Reviewing and processing all hearing related documents received in claims queues via CompHub, such as emergency hearings, rehearing, postponements, other motions and petitions, withdraw issues, etc., in accordance with the established procedures. Analyzing, reviewing and processing claim related insurance corrections. Reviewing and processing request for hearings (Issues) received in the CompHub and processing the information in accordance with the established procedures. Responsible for reviewing and processing award order corrections in accordance with the established procedures. Reviewing temporary total (TT) and compensation deferred (CD) orders for insured & non-insured claims and entering the information in CompHub in accordance with the established procedures. Reviewing and processing C-40 responses, through analyzing claims and entering required data into CompHub.
Responsible for managing incoming and outgoing telephone inquiries from employers, insurance carriers, attorneys and claimants. Provides information, gathers necessary details and resolves issues to support the accurate and timely processing of documents and claim-related insurance corrections in accordance with established procedures.
Additional duties include assisting with coverage of the reception desk, helping the public obtain copies via mail and accessing CompHub, receiving and calculating payments for copies, date-stamping and routing incoming correspondence to correct departments, processing subpoenas and ensuring forms are accurate and up-to-date.
Responsible for reviewing, coding, and processing Workers Compensation claims (regular, death and medical). Responsible for processing all claims (regular, death and medical) through CompHub for generation of copies to all essential parties. Monitor undeliverable mail notifying parties and maintain current business names and addresses.
Minimum Qualifications
Education : Graduation from an accredited high school or possession of a high school equivalency certificate.
Experience : One year of clerical experience handling compensation claims or three years of general clerical experience.
Notes
- Candidates may substitute additional general clerical experience on a year-for-year basis for the required education.
- Candidates may substitute U.S. Armed Forces military service experience as a non-commissioned officer in Workers’ Compensation Claims Examining classifications or Workers’ Compensation Claims Examining specialty codes in the Legal and Kindred field of work on a year-for-year basis for the required experience.
Selective Qualifications
The following is a required qualification. Candidates MUST possess the following:
Six months of experience working with claims from start to finish.
and
One year of data entry experience.
Desired Or Preferred Qualifications
The ideal candidate will have the following preferred qualifications:
Six months of experience in workers' compensation laws and regulations.
One Year Of Experience With Workers’ Compensation Claims.
One year of experience working with insurance companies/agencies.
Intermediate skills in Microsoft Office (Word, Excel, Outlook and PowerPoint).
SELECTION PROCESS
Please make sure that you provide sufficient information on your application to show that you meet the qualifications for this recruitment. All information concerning your qualifications must be submitted by the closing date. We will not consider information submitted after this date. Successful candidates will be ranked as Best Qualified, Better Qualified, or Qualified and placed on the eligible (employment) list for at least one year.
EXAMINATION PROCESS
The assessment may consist of a rating of your education, training, and experience related to the requirements of the position. It is important that you provide complete and accurate information on your application. Please report all experience and education that is related to this position.
Benefits
STATE OF MARYLAND BENEFITS
FURTHER INSTRUCTIONS
If you are unable to apply online, or encounter difficulty attaching required or optional documentation, you may submit via mail or deliver in person. Please be sure to include your name, identification number (Easy ID#) and job announcement number (26-002218-0001) on any documentation to ensure timely processing. Submission of a resume is strongly encouraged.
PLEASE DO NOT FAX OR EMAIL UNSOLICITED DOCUMENTATION.
Completed applications, required documentation, and any required addendums may be mailed to:
Workers' Compensation Commission
Attn: Personnel Division
10 E. Baltimore Street, 7th Floor
Baltimore, MD 21202
The MD State Application Form can be found online.
For more information, please email [email protected].
TTY Users: call via Maryland Relay
Workers' Compensation Commission is an equal opportunity employer. It is the policy of WCC that all persons have equal opportunity and access to employment opportunities, services, and facilities without regard to race, religion, color, sex, age, national origin or ancestry, marital status, parental status, sexual orientation, disability or veteran status
