Please note: State agencies that contact job applicants do not usually request personal or financial information via text message or over the phone in connection with your response to a job posting. If you are contacted for such information by these methods, or any other method, please verify the identity of the individual before transmitting such information to that person.
Note: For questions about the job posting, please contact the agency that posted this position by using the contact information provided on the "Contact" tab for the position.

Review Vacancy

Date Posted 02/03/23

Applications Due02/13/23

Vacancy ID123393

AgencyWorkers' Compensation Board

TitleWorkers' Compensation Examiner, WCB Items #3147, #8940

Occupational CategoryClerical, Secretarial, Office Aide

Salary Grade14

Bargaining UnitASU - Administrative Services Unit (CSEA)

Salary RangeFrom $51711 to $62806 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 Office of Financial Services, Special Funds

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 permanently served at least one year in a title designated as appropriate for transfer in accordance with Section 70.1 of the Civil Service law.

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 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 Job Duties include but are not limited to:
• Review requests for medical and indemnity reimbursement against SDF claim records for proper application of apportionment and SDF liability;
• Review requests for medical and indemnity reimbursement against SDF claim records to ensure that no approved requests have already been paid, which would result in an overpayment to the insurance carrier or self-insured employer;
• Review requests for indemnity reimbursement against SDF claim records and CIS to ensure that appropriate payment rates are used to calculate reimbursement amounts;
• Review requests for indemnity reimbursement against CIS to validate other requested amounts (e.g.; Section 32s, lump sum payments) are appropriate for reimbursement;
• Review requests for medical reimbursement against SDF claim records to ensure only causally related treatment to established sites is approved for reimbursement;
• Review requests for medical reimbursement against the appropriate fee schedule to ensure that no more than the applicable amount is approved for reimbursement;
• Enter results of reimbursement review into tracking database and generate responses to insurance carriers or self-insured employers as necessary;
• Audit prior payments made per claim to identify potential overpayments that must be recouped and prepare calculation/documentation of any overpayment identified;
• Draft notification of overpayment recoupment for supervisory review and distribution to insurance carrier or self-insured employer;
• Update and maintain information in SDF claim records based on results of audits and reimbursement reviews;
• Record direct payments from insurance carriers or self-insured employers, remitted to satisfy overpayments or third party pro rata shares in lieu of recoupment from reimbursement, in tracking database;
• Assist other sections within the Special Funds group with tasks or backlogs as needed, this may include, among other assignments, data entry, mail sorting or distribution, as well as review of claims files for settlement and hearing scheduling tasks;
• Assist with any special projects as assigned.

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 #3147 in the subject line of your email to ensure receipt of your application. (Please do not reference the Vacancy ID No.)

Printable Version