Review Vacancy
AgencyWorkers' Compensation Board
TitleWorkers' Compensation Examiner, WCB Item #5118
Occupational CategoryNo Preference
Bargaining UnitASU - Administrative Services Unit (CSEA)
Salary RangeFrom $48728 to $59186 Annually
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.
Duties Description The position of WC Examiner would encompass but are not limited to the following duties:
• Review Form DB-450 [Notice and Proof of Claim for Disability Benefits] to validate that it was submitted timely and contains all required information
• Review request to validate that benefit period is supported by medical documentation and does not exceed statutory maximum;
• Review request to validate that benefit rate is supported by wage documentation and does not exceed statutory maximum;
• Request additional information from claimant to support benefit period or rate as necessary and follow up when appropriate if no response received:
• Notify all parties of request disposition and transmit request to third party vendor for payment if appropriate;
• Process determination of employer violation if appropriate;
• Review Form DB-451 [Notice of Total or Partial Rejection of Claim for Disability Benefits] to validate that it was submitted timely and contains all required information:
• Request additional information from claimant to support benefit period or rate or from carrier to support rejection as necessary and follow up when appropriate if no response received;
• Prepare request for hearing if issues cannot be resolved administratively and notify all parties of hearing outcome
• Apply knowledge of applicable DB Law and Regulations and identified issues/resolutions to determine acceptance/rejection of request;
• Review and respond to written communications received via mail, fax or electronic transmittal that uses clear concise and accurate wording and is in a format complying with WCB standards;
• Respond to customer inquires by telephone or in person regarding Disability Benefits and apply knowledge of applicable DB Law and Regulations;
• Use the Image Silo application as needed for the review of Form DB-450 and attachments;
• Use the Image Silo application as needed for the review of Form DB-451 and attachments;
• Work closely with other units within the Board to ensure timely payment of benefits to short term disability claimants
• Other duties as directed by the supervisor, manager or Assistant Director of Claims.
Additional Comments *This position is being posted in anticipation of an approved DOB waiver.
Some positions may require additional credentials or a background check to verify your identity.
Address
Street Human Resources Management
328 State Street
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 #5118 in the subject line of your email to ensure receipt of your application. (Please do not reference the Vacancy ID No.)