Job Details

ID #53731597
Estado New York
Ciudad Melville
Full-time
Salario USD TBD TBD
Fuente New York State Insurance Fund
Showed 2025-03-27
Fecha 2025-03-27
Fecha tope 2025-05-26
Categoría Etcétera
Crear un currículum vítae
Aplica ya

Claims Service Representative 1/Trainee 1/2

New York, Melville, 11747 Melville USA
Aplica ya

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; and reviews case activity and determines when a claim can be retired.Specific duties to be discussed at time of interview.Minimum Qualifications:For Appointment to Claims Services Representative 1, SG-18: Reachable on current Civil Service eligible list for this title; OR 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)For Appointment to Claims Services Representative Trainee 1: Reachable on current Civil Service eligible list for this title; OR 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; OR A bachelor's or higher degree (in any area of study).Minimum Salary: 55498

Maximum Salary: 86056

Salary Unit: Yearly

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