Claims Examiner Supervisor - PN 20065810 - Cambridge

State of Ohio•Cambridge, OH

6d•Onsite

About The Position

Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. What You'll Do: Under general direction of the Administrative Officer 2 (AO2) or Program Administrator 2 or 3 (PA2/PA3): Supervises & directs (assigns & monitors) all work activities for the district / regional office staff, customer service, word processing, claims examining (all 1st & 2nd level hearing issues), & docketing Supervises lower level supervisors (customer service & program administrator 1) Interprets & applies existing workers' compensation laws, IC / BWC rules, policies & procedures & instructs personnel accordingly Follows up verbal instruction with written direction to ensure understanding & compliance Assists staff with the resolution of complex work activities Makes recommendations to AO2, PA2, PA3 or Regional Manager regarding policy & procedure changes to assure the efficient processing of claims Reviews & analyzes all queues in Case Manager, Applications (Action items, Action uploads, Power BI, VSSR, etc.) & Outlook email (ODI / ODIPT, File Drop, etc.) to ensure inventories are current Works with other claims examiner supervisors to resolve claim, word processing, docketing & report issues (open pcn reports, CAS tracking issues, etc.,) Updates information on CAS, ECM & Case Manager as needed. Prepares or routes claims for exparte orders Maintains the risk & representative master files Serves as liaison with central office departments (administration, fiscal, information technology, operations support, security services, customer service (interpreters), medical services, human resources, management planning, & claims support) & the BWC Oversees & resolves all building operational issues\: security, maintenance issues, etc., & reports concerns as needed Backs up other district office supervisors or regional program administrators as needed See the attached position description for more details regarding this position. This position is filled through an assessment consisting of a structured interview. The interview will be administered in person at the Cambridge District Office. For internal applicants, the position will be filled pursuant to legislation or the provision of the OCSEA/AFSCME Contract. This position may require travel; therefore, the person occupying this position must be able to provide his/her own transportation &/or legally operate a state-owned vehicle. Compensation statement\: The hourly wage for this position is not negotiable. For applicants who are not current State of Ohio employees, the starting wage will be the hourly rate listed on this posting. Successful employees will move up a step in the salary range within one year, and in most cases within four to six months, with subsequent step increases occurring annually. ADA Statement\: The Industrial Commission is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs, and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws. To request a reasonable accommodation due to a disability please contact the ADA Coordinator, at 614-466-2765 (voice) or by email to\: [email protected] , as-soon-as possible but at least 14 days prior to the scheduled event. Background Check Information Statement\: The final candidate selected for the position will be required to undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position. An individual assessment of an applicant's prior criminal convictions will be made before excluding an applicant from consideration. The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting. At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees. For a list of all the State of Ohio Benefits, visit our Total Rewards website ! Our benefits package includes: Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems ( such as OPERS, STRS, SERS, and HPRS ) & Optional Deferred Compensation ( Ohio Deferred Compensation ) Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position. Our mission is to serve injured workers and Ohio employers through expeditious and impartial resolution of issues arising from workers' compensation claims and through the establishment of adjudication policy. The Ohio Industrial Commission (OIC), Cambridge Office, is seeking a seasoned claims examiner with innate leadership and communication skills, as well as in-depth and nuanced knowledge of all first and second level hearing issues including specifically in the areas of PTD and VSSR processing. A successful candidate must be able to work well independently. An accessible communication style and infinite patience are a plus.

Requirements

3 yrs. trg. or 3 yrs. exp. in workers' compensation claims processing operation, 6 mos. of which had to have been as supervisor or lead worker.
-Or in District Offices, 3 yrs exp. as Claims Examiner 2, 16792 or 30 mos. as Claims Examiner 3, 16793.
-Or equivalent of Minimum Class Qualifications for Employment noted above.
Claims Examination
Management
Customer Service
Training
Communications
Attention to Detail
Developing Others
Critical Thinking
Problem Solving
Time Management

Nice To Haves

innate leadership and communication skills
in-depth and nuanced knowledge of all first and second level hearing issues including specifically in the areas of PTD and VSSR processing
An accessible communication style and infinite patience are a plus.
A successful candidate must be able to work well independently.

Responsibilities

Supervises & directs (assigns & monitors) all work activities for the district / regional office staff, customer service, word processing, claims examining (all 1st & 2nd level hearing issues), & docketing
Supervises lower level supervisors (customer service & program administrator 1)
Interprets & applies existing workers' compensation laws, IC / BWC rules, policies & procedures & instructs personnel accordingly
Follows up verbal instruction with written direction to ensure understanding & compliance
Assists staff with the resolution of complex work activities
Makes recommendations to AO2, PA2, PA3 or Regional Manager regarding policy & procedure changes to assure the efficient processing of claims
Reviews & analyzes all queues in Case Manager, Applications (Action items, Action uploads, Power BI, VSSR, etc.) & Outlook email (ODI / ODIPT, File Drop, etc.) to ensure inventories are current
Works with other claims examiner supervisors to resolve claim, word processing, docketing & report issues (open pcn reports, CAS tracking issues, etc.,)
Updates information on CAS, ECM & Case Manager as needed.
Prepares or routes claims for exparte orders
Maintains the risk & representative master files
Serves as liaison with central office departments (administration, fiscal, information technology, operations support, security services, customer service (interpreters), medical services, human resources, management planning, & claims support) & the BWC
Oversees & resolves all building operational issues\: security, maintenance issues, etc., & reports concerns as needed
Backs up other district office supervisors or regional program administrators as needed

Benefits

Medical Coverage
Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
Childbirth, Adoption, and Foster Care leave
Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
Public Retirement Systems ( such as OPERS, STRS, SERS, and HPRS ) & Optional Deferred Compensation ( Ohio Deferred Compensation )

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