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Review Vacancy

Date Posted 06/13/18

Applications Due06/23/18

Vacancy ID54217

AgencyWorkers' Compensation Board

TitleMedical Care Representative, WCB Item #4271

Occupational CategoryHealth Care, Human/Social Services

Salary Grade19

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $59671 to $75785 Annually

Employment Type Part-Time

Part-time Percent 50%

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5


From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? No

County Albany

Street Address Medical Director's Office, Medical Guidelines Unit

150 Broadway

City Menands


Zip Code12204

Minimum Qualifications Candidates must be reachable on the appropriate Civil Service list. Only permanent Medical Care Representatives are eligible for transfer.

Duties Description Under the direct supervision of the Supervising Medical Care Representative, SG-23, the Medical Care Representative, SG-19, will be responsible for the medical review and preparation of files for disputed medical bill resolution via the WCB arbitration process. The incumbent must be knowledgeable of NYS Workers’ Compensation law, rules and regulations and appropriately represent the Workers’ Compensation Board while interacting with healthcare providers, carriers, and arbitrators. Specific duties of the Medical Care Representative include, but are not limited to: Following review of the HP-1 arbitration request by the SG-14 WC Examiner and final approval by SG-18 Senior WC Examiner, perform a comprehensive medical review of billing/reporting codes and supporting documentation to ensure that the services billed are appropriate for the services rendered; reviewing the arbitration request, associated bills and documentation to ensure the applicable fee schedule amount in dispute is based on the correct interpretation of the Workers’ Compensation Board Fee Schedules and associated Ground Rules and Regulations; preparing a written summary of all issues in the dispute; representing the Workers’ Compensation Board at desk and panel arbitration hearings; and promoting communication between providers and payers to resolve disputes outside of the arbitration process by explaining WC Law, fee schedules and applicable Ground Rules.

Additional Comments Qualified 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 (email applications are preferred). It is important that you reference the WCB Item #4271 in the subject line of your email to ensure receipt of your application. (Please do not reference the Vacancy ID No.)

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

Name Recruitment Unit

Telephone 518-474-2685

Fax 518-486-6364

Email Address HRM@WCB.NY.GOV


Street Human Resources Management

328 State Street

City Schenectady

State NY

Zip Code 12305


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