Workers' Compensation Specialist I Job Listing at State of Vermont in Montpelier, VT (Job ID 5578A999-2B1D-4)

Description

Overview

Claims management work of a highly technical nature in the Department of Labor for reports of workplace injury, reviewing for proper and timely filing, legal compliance, correct adjustment, and appropriate disposition of claims. Incumbent is assigned initial filings and pre-dispute claims for review and disposition. Supervision is close during the first year in the class with more independence of action and complex cases being added in accordance with incumbent progress in the role. Significant communication with trading partners, employers, claimants, carriers and attorneys is involved. Duties are performed under the supervision of the Workers' Compensation Program Manager.

 

Performs a review of a variety of Workers' Compensation claims and employer or insurance company responses to such claims, including cases of temporary partial disability, temporary total disability, permanent partial disability, and dependent benefits. Ensures compliance with regulatory requirements in relation to payment rates, periods of payment, changes in rate, discontinuances of payment, timely filing of required submissions, and pre-dispute claim adjustment. Advises stakeholders of errors and needed corrective action regarding correct amounts paid, payments made on the correct date, and payments continuing until an approved discontinuance. Mediates pre-dispute problems by phone, email, and letter in the interest of avoiding formal dispute. Performs related duties as required.

 

Duties are performed in a standard office setting. There is regular phone and written contacts with employers, claimants, and insurance carriers. Incumbent must be skilled in dispute resolution and customer service, remaining both tactful and firm in an attempts to secure proper claim resolution. Incumbent must be comfortable communicating professionally with individuals who are emotionally upset, resistant to or unfamiliar with the process, or disputatious.

 

Knowledge, Skills, and Abilities
•    Ability to gain expert knowledge of records management principles and procedures
•    Ability to gain expert knowledge in the use of a public records submission portal, bespoke claims management database, and multiple communications and scheduling platforms
•    Full understanding of the purpose of Workers' Compensation insurance programs
•    Ability to quickly gain facility with advanced medical  and insurance terminology
•    Ability to correctly read, understand, apply, and explain regulations, industry terminology, and medical reports of modest to significant complexity
•    Ability to communicate effectively as required in the class role
•    Ability to review and analyze case review records to evaluate and determine the accuracy of data in terms of applicable criteria
•    Ability to establish and maintain effective working relationships

Who May Apply

This position, Workers' Compensation Specialist I (Job Requisition #51295), is open to all State employees and external applicants.
If you would like more information about this position, please contact berrian.eno-vanfleet@vermont.gov.
Please note that multiple positions in the same work location may be filled from this job posting.
Resumes will not be accepted via e-mail. You must apply online to be considered.

Environmental Factors

Duties are performed in a standard office setting. There is regular phone and written contacts with employers, claimants, and insurance carriers. Incumbent must be skilled in dispute resolution and customer service, remaining both tactful and firm in an attempt to secure proper claim resolution. Incumbent must be comfortable communicating professionally with individuals who are emotionally upset, resistant to or unfamiliar with the process, or disputatious.

Minimum Qualifications

High school diploma or equivalent AND two (2) years at or above a senior clerical level of responsibility, including one (1) year of direct interaction with and/or service to the public or other organizations.

OR

Associate degree AND one (1) year of direct interaction with and/or service to the public or other organizations.

Total Compensation

As a State employee you are offered a great career opportunity, but it's more than a paycheck. The State's total compensation package features an outstanding set of employee benefits that are worth about 30% of your total compensation, including:

• 80% State paid medical premium and a dental plan at no cost for employees and their families
• Work/Life balance: 11 paid holidays each year and a generous leave plan
• State Paid Family and Medical Leave Insurance (FMLI)
• Two ways to save for your retirement: A State defined benefit pension plan and a deferred compensation 457(b) plan
• Tuition Reimbursement
• Flexible spending healthcare and childcare reimbursement accounts
• Low cost group life insurance
• Incentive-based Wellness Program
• Qualified Employer for Public Service Student Loan Forgiveness Program

Want the specifics? Explore the Benefits of State Employment on our website.

Equal Opportunity Employer The State of Vermont celebrates diversity, and is committed to providing an environment of mutual respect and meaningful inclusion that represents a variety of backgrounds, perspectives, and skills. The State does not discriminate in employment on the basis of race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, membership in an employee organization, family medical history or genetic information, or family or parental status. The State's employment decisions are merit-based. Retaliatory adverse employment actions by the State are forbidden.

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