Worker's Compensation Examiner - Madison, United States - WISC
Description
Worker's Compensation Examiner (Entry or Senior) - 2 Openings2 weeks ago
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Introduction
Join an organization that strives to exceed customer expectations by delivering efficient, high-quality state government services.
DOA provides direct services to state agency stakeholders and designs and leads initiatives to make government more innovative and cost-effective.
Working at DOA offers you the opportunity to make an impact on the quality of life in Wisconsin.Introduction
Join an organization that strives to exceed customer expectations by delivering efficient, high-quality state government services.
DOA provides direct services to state agency stakeholders and designs and leads initiatives to make government more innovative and cost-effective.
Working at DOA offers you the opportunity to make an impact on the quality of life in Wisconsin.The Division of Enterprise Operations (DEO)
administers enterprise policies governing procurement, risk management, and continuity of operations planning; provides services to DOA and other agencies in the areas of financial management, procurement, risk management, continuity of operations planning, and the State Prosecutors Program; and facilitates opportunities for diverse businesses to sell goods and services to state agencies.
Diversity, Equity, Inclusion, and Belonging are core values at DOA that guide how we build our teams, develop our leaders, and create a culture that empowers everyone to be their authentic selves.
We believe that when employees are respected and valued for who they are and are accountable for demonstrating that respect to others; it drives greater engagement and collaboration, ignites creativity and innovation, and fosters connection between teams and those we serve .
Position SummaryWorker's Compensation Examiner (Entry):
Under the close supervision of the Worker's Compensation Claims Manager of the Bureau of State Risk Management in the Department of Administration, this position independently manages an assigned portion of state employee worker's compensation disability claims as part of the claims management operations of the State's self-funded Worker's Compensation program.
benefits.
The examiner thoroughly investigates claims and makes a timely recommendation of liability, including contacting the employee, the supervisor, and the medical provider for information about the claim and taking recorded statements from injured employees.
The examiner investigates and evaluates medical and vocational treatment and services and recommends employing medical reviews, case management, medical bill auditing, and vocational resources.
The examiner recommends and prepares requests for independent medical examinations as required.The examiner investigates cases for compliance with worker's compensation statutes, recommending use of private investigations, including video surveillance, and investigates potential fraud.
The examiner evaluates the potential for third party lawsuits and notifies all parties of the state's subrogation interests. The examiner prepares draft responses to applications for hearings on disputed claims for review by the claim's supervisor and toassist the Program's dispute resolutions manager.
The examiner works closely with each assigned agency's worker's compensation coordinator. The position requires the examiner to assist in the training of coordinators and provide guidance to other agency personnel.
The examiner will assist agencies in the development of early return to work and transitional duty programs, striving to restore the injured worker to a pre-injury health status and gainful employment.
For more details on the duties of the position, please view the complete position description .Worker's Compensation Examiner – Senior
Under general supervision of the Worker's Compensation Program Manager of the Bureau of State Risk Management in the Department of Administration, this position independently manages an assigned portion of State employee worker's compensation claims as part of the State's self-funded Worker's Compensation program.
The examiner receives claims for compensation and supporting evidence from over fifty state agencies and subdivisions.
The senior position requires the application of advanced knowledge of worker's compensation law, administrative rules, medical and legal terminology, and hazardous duty disability benefits.
The examiner manages highly complex claims by thoroughly investigating and making a timely determination of compensability. This investigation includes contacting the injured employee, the supervisor, and the medical provider for information about the claim. The examiner issues timely, appropriate worker's compensation disability and medical benefits and sets appropriate claim reserves.The examiner investigates and evaluates medical and vocational treatment and orders medical reviews, vocational evaluation, and medical case management, when appropriate.
The investigation also requires the examiner to maintain compliance with worker's compensation statutes.The examiner assists the Bureau's Subrogation Specialist in identifying potential third party recovery potential and provides guidance with third party distributions forms.
The examiner will prepare a response to an application for hearing on disputed claims and will partner with the Department of Justice legal counsel in preparing claims with a defense strategy.
The senior examiner negotiates settlements directly with claimants; Petitioner's Attorneys and/or extends authority to the Assistant Attorney General at the Department of Justice to negotiate the settlement.
The senior examiner designs, develops, and provides training and technical assistance for internal claims personnel and all state agencies workers compensation coordinators.
The position serves as technical resource to the Examiner – Entry and Claim Representatives.The position requires knowledge of and the ability to use the electronic Risk Management Information System.
The examiner performs all aspects of this job independently, subject to the general supervision of the Workers Compensation Program Manager.
For more details on the duties of the position, please view the complete position description .Classification level will be determined based on the selected applicant's qualifications and experience
Salary Information
Worker's Compensation Examiner - Entry:
This classification is in schedule-range with an
hourly rate of $ $33.36
(depending upon qualifications), plus excellent benefits. A 12-month probation period is required. Pay for current state employees will be set in accordance with the Wisconsin State Compensation Plan.
Worker's Compensation Examiner - Senior:
This classification is in schedule-range with an
hourly rate of $ $43.46 (depending on qualifications), plus excellent benefits. A 12-month probation period is required. Pay for current state employees will be set in accordance with the Wisconsin State Compensation Plan.
Job Details
Due to the nature of the position, DOA will conduct background checks on applicants prior to selection. DOA does not sponsor work visas.
All persons hired will be required to verify identity and eligibility to work in the United States, and to complete the required employment eligibility form.
QualificationsQualified applicants will have experience as it relates to:
Use of Microsoft Office products or other data entry software (e.g. Word, Excel, PowerPoint, Access, etc.)
Interpreting and applying state statute, administrative code, policy language or similar
Making determinations for eligibility of specific programs or benefits.
In Addition, Well Qualified Applicants Will Also Have Experience
Managing Worker's Compensation claims (e.g. reviewing claims, tracking, monitoring activities, etc.)
Interpreting and applying Statutes with job duty decision making (this may include Wis. Statutes Chapter 102 or other similar Statutes regarding worker's compensation)
In addition to the above, candidates at the senior level will also have experience:
Utilizing an RMIS (Risk Management Information System)
Negotiation/litigation (e.g. developing litigation summaries, calculating case exposures, preparing claims for defense strategies, or similar)
How To Apply
Apply online To apply, click "Apply for Job" to start the application process. Then, you will access your existing account or to create a new account if you don't have an account.
Once you are logged in, click "Apply for Job." Follow the steps outlined in the application process and submit your application.
Please visit the Frequently Asked Questions section for general user information and technical assistance.
Your letter of qualifications and resume are very important parts of your application and are used during our evaluation process to determine your qualifications as they relate to the job.
Your cover letter is limited to a maximum of two (2) typed pages, single-spaced, no smaller than 10-point font, with 1-inch margins.
Resumes should be limited to no more than two (2) pages (no format requirements). Pages more than the specified limits may not be evaluated. References are not necessary at this stage of the process.
Submitted materials will be evaluated and the most qualified applicants will be invited to participate in the next step of the hiring process for available vacancies.
Permanent classified state employees who are eligible for consideration (transfer or voluntary demotion) should complete the application process as described above by the stated deadline.
If you are a veteran with a 30% or greater service-related disability and are not currently employed in a permanent position with Wisconsin State Government, please send a cover letter, resume, DD-214 and documentation of your service-connected disability rating (dated within 12 months) to the contact listed below.
Deadline to Apply
Applicant materials are due by 11:59pm on Tuesday, April 30, 2024.
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