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Review Vacancy

Date Posted 08/04/22

Applications Due08/19/22

Vacancy ID109913

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%

Workweek Mon-Fri

Hours Per Week 37.5


From 8:30 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Suffolk

Street Address 8 Corporate Center Drive

City Melville


Zip Code11747

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.


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.

Name Kelly Rhatigan


Fax (518) 437-1618

Email Address


Street PO BOX 66699

City Albany

State NY

Zip Code 12206


Notes on ApplyingCandidates should email resume and cover letter to Please include the position title, Vacancy ID number, and your current Civil Service title on your cover letter.

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