Review Vacancy
Date Posted: 08/04/22
Applications Due: 08/19/22
Vacancy ID: 109913
Position Information
AgencyInsurance Fund, State
TitleClaims Services Representative 1/Trainee 1/2
Occupational CategoryOther Professional Careers
Salary GradeNS
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $46529 to $77912 Annually
Employment Type Full-Time
Appointment Type Permanent
Jurisdictional Class Competitive Class
Travel Percentage 10%
Schedule
Workweek Mon-Fri
Hours Per Week 37.5
Workday
From 8:30 AM
To 5 PM
Flextime allowed? No
Mandatory overtime? No
Compressed workweek allowed? No
Telecommuting allowed? Yes
Location
County Suffolk
Street Address 8 Corporate Center Drive
City Melville
StateNY
Zip Code11747
Job Specifics
Minimum Qualifications Claims Services Representative 1 (SG-18): One year of permanent, competitive class service in a title eligible for transfer under Section 70.1 of the Civil Service Law. Eligible titles include, but are not limited to: Administrative Specialist 1, Investigator 2 (Compensation Claims), Policyholder Services Representative 1, Underwriter 1, Underwriter 1 (Disability Benefits).
Claims Services Representative Trainee 1 (NS): One year of permanent, competitive class service in a title eligible for transfer under Section 70.1 of the Civil Service Law. Eligible titles include, but are not limited to: Investigator 1, Assistant Insurance Fund Services Representative, Program Aide.
If you have questions about whether your current title is eligible for transfer, please contact the Personnel Department.
Candidates with a score of 100 or higher on the current PCO eligible list who are eligible for appointment are encouraged to apply. Please note your score of this exam in your cover letter.
Duties Description Under the general supervision of a Claims Services Representative 2, oversees all aspects of workers compensation claims processing from inception to closing; initially determines the compensability of claims and files appropriate documentation with the Workers Compensation Board (WCB); calculates and adjusts reserves consistent with case analysis over the anticipated life of the claim; recommends cases for appeal to WCB; negotiates and/or makes recommendations regarding lump sum settlements; issues payments and requests for reimbursement where claims for supplemental benefits are involved; reviews awards to ensure the correct recipient and rate of compensation; schedules or waives medical examinations as necessary; analyzes medical bills to determine causality, levels of treatment, necessity for treatment, appropriateness of fees and procedure codes, and apportionment status; responds to requests for home modifications, home health care personnel, medication, and medical supplies and appliances; negotiates billing adjustments with medical care providers and suppliers applying workers compensation fee schedules and rules; identifies and initiates referrals to the Legal Department; and reviews case activity and determines when a claim can be retired.
Specific duties to be discussed at time of interview.
Additional Comments YOU MUST BE A CURRENT STATE EMPLOYEE TO BE ELIGIBLE FOR TRANSFER TO THIS POSITION.
This position may be designated 55 b/c and is subject to verification of applicant eligibility.
NYSIF has a telecommuting policy.
Some positions may require additional credentials or a background check to verify your identity.
Contact Information
Name Kelly Rhatigan
Telephone
Fax (518) 437-1618
Email Address hr@nysif.com
Address
Street PO BOX 66699
City Albany
State NY
Zip Code 12206
Notes on ApplyingCandidates should email resume and cover letter to hr@nysif.com. Please include the position title, Vacancy ID number, and your current Civil Service title on your cover letter.
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