Minimum Qualifications FOR CURRENT NYS EMPLOYEES (for permanent appointment):
One year of permanent, competitive class service in a title eligible for transfer under Section 70.1 of Civil Service Law.
Eligible titles include, but are not limited to: Administrative Assistant 1, Business Document Specialist 2, Motor Vehicle Consumer Services Representative, Licensing Examiner 1, Taxpayer Services Representative 1, Program Aide, Payroll Examiner 1.
FOR CANDIDATES THAT ARE NOT CURRENT NYS EMPLOYEES (for provisional appointment):
Candidates must have four years of customer service experience that required independence in both verbal and written communication responsibilities; OR an associate degree or higher and two years of this experience.
Preferred candidates will also have experience in the development or processing of insurance claims or responding to technical questions from policyholders or claimants.
Duties Description The New York State Insurance Fund (NYSIF) is hiring multiple Insurance Claims Representatives to support the Workers' Compensation and Disability Benefits business operations. Candidates hired for this position will be versatile in their duties to support both policyholder services and claims services for NYSIF.
Duties Description: Duties may include, but are not limited to:
- Maintain caseloads and assignments for specified policyholders and employers providing various services throughout a life cycle.
- Review all work products for accuracy and completeness and determine whether additional information is required.
- Accurately process caseloads and work in designated systems, efficiently enough to maintain and meet required deadlines which prevent the agency from incurring penalties.
- Work with policyholders to qualify and quantify an employee/claimant.
- Communicate with claimants, policyholders, medical providers, and various entities to gather information needed to process assigned work.
- Examine accident and medical reports to determine compensability and liability, seeking guidance and expertise as needed if complex medical issues arise, and initiate proactive follow ups for all updated information as needed.
- Conduct research to cross check current, existing, or past payments being provided to check the coordination of claims, if applicable.
- Provide any additional information required to assist various internal agency Departments in reviewing unique and/or complex scenarios and work with the Departments to implement the recommendations.
- Acquire an understanding of the NYS Workers’ Compensation Law, Disability Benefits Law and/or the Paid Family Leave Benefits Law, and all other applicable New York State laws, rules and regulations related to programmatic operations.
- Establish a comprehensive knowledge of the resources available to resolve issues and answer questions about assignments.
- Develop expertise and proficiency related to the NYS COVID-19 legislation authorizing sick leave for employees subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19.
- Keep complete records and internal controls utilizing a variety of internal systems.
- Provide customer service to all claimants, policyholders, medical providers and brokers, and internal agency staff, responding in a timely manner to all inquiries from any source including telephone, email, letter, and web inquiry.
- Work with agency staff on special projects as directed.
Some positions may require additional credentials or a background check to verify your identity.
Notes on ApplyingCandidates should email a resume and cover letter to firstname.lastname@example.org. Please include the position title and Vacancy ID number in the subject line of your email. If current NYS employee, please list your official NYS civil service title in your submission.