StateJobsNY

NY HELPNo

AgencyWorkers' Compensation Board

TitleWorkers' Compensation Examiner, WCB Items #2362, #3149, #3150

Occupational CategoryClerical, Secretarial, Office Aide

Salary Grade14

Bargaining UnitASU - Administrative Services Unit (CSEA)

Salary RangeFrom $49703 to $60371 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 8:30 AM

To 4:30 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Schenectady

Street Address Medical Director's Office, Fee Schedule and Medical Billing Unit

328 State Street

City Schenectady

StateNY

Zip Code12305

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

OR

Candidates must have at least one year of permanent competitive service in a title designated as appropriate for transfer in accordance with Section 70.1 of the Civil Service Law.

Candidates holding a permanent position of Workers' Compensation Examiner may be eligible for reassignment or transfer.

Provisional Qualifications:

Promotion:
Must be a qualified employee of the New York State Workers’ Compensation Board with one year of permanent competitive, non-competitive, labor, or 55-b/55-c service in a position allocated to a Grade 9 or higher.

Open-Competitive:
Candidates must have four years of experience examining, investigating, or adjusting compensation, accident, liability or health insurance claims. A bachelor’s degree or higher may substitute for three years of this experience. An associate’s degree may substitute for two years of this experience.

If appointed provisionally, the incumbent will need to take the next Civil Service examination for this title and pass with a score that will be immediately reachable on the resulting eligible list. Failure to take, pass and achieve a reachable score on the examination may result in revocation of the appointment.

Duties Description The Fee Schedules & Medical Billing Unit reviews and processes requests from health care providers relative to unpaid and disputed medical bills via the Board’s administrative award process and/or the arbitration process. The WC Examiner processes Requests for Decision on Unpaid Bills (Form HP-1.0).
Duties include, but are not limited to:
• Review Requests for Decision on Unpaid Bills (Form HP-1.0) for required documentation and issue awards
• Prepare letters of rejection, as appropriate
• Approve and prepare HP-2 awards for accepted requests using HPA system
• Maintain accurate daily results of accepted and rejected requests
• Issue awards in a timely manner conforming to the direction of the unit supervisors
• Ensure timely and appropriate handling of all incoming carrier objections to an Administrative Award (HP-2)
• Determine validity of objections and ensure accurate application of WC Law, Rules, Regulations, Policy and Procedures
• Draft responses to inquiries received from external stakeholders
• Promptly answer incoming calls from external stakeholders
• Assist with special projects as needed
• Maintain up-to-date knowledge of regulations and processes related to handling HP-1s.

Additional Comments Please Note: A telecommuting schedule can be discussed with the hiring manager during the interview.

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

Name Recruitment Unit

Telephone

Fax 518-486-6364

Email Address HRM@WCB.NY.GOV

Address

Street Human Resources Management

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 Item #2362 in the subject line of your email to ensure receipt of your application. (Please do not reference the Vacancy ID No.)