VICTIM COMPENSATION CLAIMS ANALYST - 41000609

State of Florida • Tallahassee, FL

6d • Onsite

About The Position

The incumbent in this position serves the primary role of processing claim and payment determinations in the Bureau of Victim Compensation and plays an integral role in the overall effectiveness and efficiency of the program through daily activities in the claims process. Duties associated may include the following: Resolve compensability issues and independently determine eligibility for victim compensation benefits in accordance with established statutes, administrative rules, and procedures within two business days of receipt and with no margin of error; or, process and resolve caller inquiries received via the Automated Call Distribution toll-free victim services information and referral line, provider line, or agency call center.

Requirements

• Three (3) years of relevant clerical or administrative experience in the areas of: accounting; claims processing; claims or benefits eligibility determination; social or victim services; disability examiner; claims adjuster; insurance adjuster; or case manager processing eligibility and benefit payments.
• A bachelor's degree from an accredited college or university can substitute for required work experience.
• A high school diploma (or equivalent) can substitute for one year of required work experience.

Nice To Haves

• Fluent in Spanish.

Responsibilities

• Perform criminal history background checks for victims and applicants seeking victim compensation and/or property loss benefits using the Criminal Justice Information System, with no margin of error.
• Contact law enforcement and criminal justice entities concerning claims to assess statutory elements of eligibility for benefits, as well as obtain information regarding the status of prosecution and restitution.
• Contact victims telephonically to provide an introduction, status information, and/or instructions within two business days of claim assignment.
• Contact vendors, advocates, employers, treatment providers, contractors, and/or collateral sources to verify costs directly related to the criminal victimization, and to verify that collateral sources are exhausted prior to payment by the trust fund, if applicable.
• Authorize payments in accordance with established statutes, administrative rules, and procedures.
• Identify potential subrogation activities, and handle refund/recoupment/restitution issues as needed.
• Respond to inquiries and concerns received via telephone, email, fax, or mail, within two business days of receipt.
• Communicate effectively both orally and in writing by providing information that is professional, clear and well understood.
• Resolve problems and complaints without escalation and with minimal referral to supervisors.
• Demonstrate sensitivity and awareness while adhering to confidentiality practices.
• Recognize obligations in the transparency of public records laws to record activities in a concise and impartial manner.
• Perform Automated Call Distribution duties as needed.
• Based on monthly statistical reports, achieve quantitative measurements of aptitude no less than 50 claim determinations processed, and 30 expenses paid monthly.
• Finalizes quality assurance corrective actions within five business days of notification.
• Makes referrals as appropriate to other service providers based on the nature of the inquiry.
• Accurately enter caller information, type of service provided, and actions taken into the database used to manage compensation claims, and/or the call tracking system.
• Resolve in-coming calls consistent with the rate in which calls are received and comparable with the volume resolved by other department call center staff.
• Alternatively, if assigned to returning calls, resolve within 48 hours the message was received.
• Based on monthly statistical reports, achieve quantitative measurements of aptitude no less than the minimum range averaging 52 - 62 live/return calls daily.
• Complete special projects as requested and finalize directives within established time frames.

Benefits

• Annual and Sick Leave benefits.
• Nine paid holidays and one Personal Holiday each year.
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
• Retirement plan options, including employer contributions.
• Flexible Spending Accounts
• Tuition waivers.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED