State of Connecticut Executive Branch

Claims Analyst (0399AR)

$34.85-$44.01 Hourly / $2,787.67-$3,520.35 BiWeekly /
$72,758.00-$91,881.00 Yearly

PURPOSE OF JOB CLASS (NATURE OF WORK)

In the Office of the State Treasurer this class is accountable for independently performing a full range of professional tasks in the review and analysis of workers’ compensation claims and coordination of other related program activities.

SUPERVISION RECEIVED

Works under the general supervision of an employee of higher grade.

SUPERVISION EXERCISED

May lead/supervise lower level employees as assigned.

EXAMPLES OF DUTIES

  • Reviews legal and medical documentation relevant to pending workers’ compensation claims to determine liability and/or eligibility; 
  • Acts as liaison between attorneys, insurance carriers and others to obtain information necessary to determine liability, eligibility and/or compensability; 
  • Analyzes claim information and identifies issues regarding liability and/or eligibility; 
  • Monitors cases to ensure accuracy of continued benefit; 
  • Recalculates benefit payments to determine accuracy of amounts and duration; 
  • Determines action plan to facilitate employee return to work or settlement of claim; 
  • Negotiates settlements; 
  • Identifies and works to recover payments; 
  • Prepares demand letters and liens; 
  • Processes requests for reimbursement from carriers and self-insurers for payments made to claimants; 
  • Submits recommendations on claim transferability or contested liability to Special Funds Administrator; 
  • Drafts transfer agreements; 
  • Schedules pre-hearing conferences on contested transfer claims; 
  • Assists Office of the Attorney General in case hearing preparation; 
  • Prepares files for transfer to Second Injury Fund Claims Examination Unit; 
  • Assists in establishment of policies and procedures; 
  • Trains new employees as necessary; 
  • May represent, attend or assist in preparation of informal or formal hearings; 
  • Performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

  • Considerable knowledge of and ability to interpret and apply workers' compensation statutes and regulations; 
  • Knowledge of medical terminology; 
  • Considerable
    • oral and written communication skills; 
    • interpersonal skills; 
  • Ability to
    • read, understand and interpret legal documents and other written materials; 
    • utilize computer software.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

Six (6) years of experience in the case management of workers' compensation claims.

MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED

  • College training may be substituted for the General Experience on the basis of fifteen (15) semester hours equalling one-half (1/2) year of experience to a maximum of four (4) years for a Bachelor's degree.
  • Certification as a Workers' Compensation Claims Law Associate (WCCLA) may be substituted for two (2) years of the General Experience.
  • Possession of a current State of Connecticut Workers' Compensation Casualty Adjuster License may be substituted for one (1) year of the General Experience.

JOB CLASS DESIGNATION

Classified/Competitive

OCCUPATIONAL GROUP

(04)-Business Management

BARGAINING UNIT

(16)-ADMIN & RESID (P-5)

EEO

(2)-Professional

SALARY INFORMATION

AR 21

ACKNOWLEDGEMENT

As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes. As such, a job class is not meant to be all inclusive of every task and/or responsibility.

CANCELLATION CLAUSE

This replaces the existing specification for the class of Claims Analyst in Salary Group AR 21 approved effective February 15, 2012. (Revised to modernize format and add Acknowledgement section) Final No. 23-138

EFFECTIVE DATE

07/12/2023
CLASS: 0399AR; EST: 4/15/1994; REV: 7/26/2023;