BEWC07-12138-Claims Specialist-Cheyenne or Laramie (Teton Village)

Compensation

: $63,220.00 - $98,320.00 /year *

Employment Type

: Full-Time

Industry

: Financial Services - Insurance



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BEWC07-12138-Claims Specialist-Cheyenne or Laramie
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BEWC07-12138-Claims Specialist-Cheyenne or Laramie
Salary
$19.58 - $25.23 Hourly
Location
Statewide, WY
Job Type
Full Time
Department
053-Administration - Workers' Safety & Compensation
Job Number
12138
+ Description
+ Benefits
+ Questions
Description and Functions
Open Until Filled
GENERAL DESCRIPTION:
Performs case management function of Workers' Compensation for assigned employer accounts and determines compensability of cases and monitors for fraud and improprieties.
Human Resource Contact: 307-###-####
ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function which may be performed in the job level.
+ Use case management skills to guide customers through the Workers' Compensation benefits program.
+ Review injury reports.
+ Investigate circumstances of injuries.
+ Make eligibility determinations on claims for benefits by reviewing applications and medical reports.
+ Process claims for indemnity benefits.
+ Communicate clearly the rights, responsibilities and benefits of the Workers' Compensation program.
+ Assist injured workers with filing requirements and in understanding the complex claims processes.
+ Refer appropriate cases for hearing and may provide testimony in the hearings.
+ Respond directly to employers or vendors in regards to questions on procedures or status of cases or claims.
+ Coordinate return to work and work restriction with healthcare providers and employers.
+ Analyze medical documentation to determine compensability of claims.
+ Initiate and monitor program requirements and process benefits.
+ Mediate disputes involving injured workers, employers, healthcare providers and the division.
+ Coordinate with healthcare providers to effectively manage the compensable injury and establish appropriate diagnoses and treatment plans for the injury.
Qualifications
PREFERENCES:
Preference may be given to those with Claims Management and/or Claims Service experience.
Preference may be given to those with Customer Service experience.
Preference may be given to those with a Bachelor's degree in Management and/or Social Services.
KNOWLEDGE:
+ Knowledge of Workers' Compensation Law and Rules & Regulations.
+ Ability to assist clients in working through complex processes.
+ Ability to work independently.
+ Ability to analyze situations and provide resolutions within the statutes.
+ Knowledge of medical terminology
+ Knowledge of case management
+ Knowledge of customer service
MINIMUM QUALIFICATIONS:
Education:
Bachelor's Degree
Experience:
0-1 year of progressive work experience (typically in Benefits and Eligibility)
OR
Education & Experience Substitution:
3-4 years of progressive work experience (typically in Benefits and Eligibility)
Certificates, Licenses, Registrations:
None
Necessary Special Requirements
NOTES:
+ FLSA: Non-exempt
+ All new hires or rehires starting in a non-exempt position on or after January 1, 2018 are required to be paid hourly.
+ Former State of Wyoming employees who are rehired less than 31 days after their final day in their old agency, must repay all leave payouts.
+ The Wyoming Department of Workforce Services (DWS) uses E-Verify, an Internet-based system, to confirm the eligibility of all newly hired employees to work in the United States. Learn more about E-Verify, including your rights and responsibilities.
+ For Veteran's preference consideration, supporting documentation must accompany your application.
+ Position location will be in Cheyenne or Laramie.
Supplemental Information
053-Department of Workforce Services - Administration - Workers' Safety & Compensation
Click here to view the State of Wyoming Classification and Pay Structure.
URL: overnmentjobs.com/wyoming/default.cfm
The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.
Class Specifications are subject to change, please refer to the A & I HRD Website to ensure that you have the most recent version.
There are many benefits to living and working in Wyoming. Beautiful country with wide open spaces and clean air, great recreational opportunities, and no State income tax to mention a few! In addition, the State of Wyoming offers State employees a very generous benefit package. Please click here for more information on the State of Wyoming employee benefits*.
For additional information on living in the state of Wyoming please click here.
Associated topics: automobile, bodily, casualty, claim, claim adjuster, claim examiner, damage, insurance, insurance adjuster, title examiner * The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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