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CLAIMS REVIEWER I

Internal Only

Recruitment #21-002218-0001

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GRADE

Grade 8

LOCATION OF POSITION

10 E Baltimore, Baltimore, MD 21202

POSITION DUTIES

To review, analyze, investigate, and process Workers' Compensation claims and related documents, and route action documents sent to claims queues to appropriate parties via the Filenet scanning system in an equitable and timey manner which also includes hearing related findings per the established rules and procedures of the Workers' Compensation law.
Responsible for reviewing and processing claim related documents received in the claims queues including wages statements, enter/strike appearances via the FileNet scanning system in accordance with the established procedures. Reviewing and processing all hearing related documents received in claims queues via the FileNet scanning system, such as emergency hearings, rehearing, postponements, other motions and petitions, withdraw issues, etc. in accordance with the established procedures. Reviewing and processing request for hearings (Issues) received in the FileNet queues and entering the information into the AS-400 in accordance with the established procedures.

Responsible for reviewing, coding, and processing Workers Compensation claims (regular, death, and medical). Responsible for processing all claims (regular, death and medical) through the AS400 database for generation of copies to all essential parties. Monitor undeliverable mail-notifying parties and maintaining current business names and addresses. 

Responsible for handling incoming and outgoing telephone inquiries from employers, insurance companies, attorneys, and claimants that require further clarification or additional information for processing documents received in accordance with the established procedures. Providing backup coverage for the Public Service Division for incoming inquiries. Analyzing, reviewing and processing claim related insurance corrections. 

Responsible for reviewing and processing award order corrections in accordance with the established procedures. Reviewing temporary total (TT) and compensation deferred (CD) orders for insured & non-insured claims and entering the information in the AS-400 in accordance with the established procedures.  Reviewing and processing C-40 responses, through analyzing claims and entering required data into the AS-400 and FileNet database.

Responds and arranges reservations for request for interpreters by email, phone call, or internet scheduling; schedules interpreters for the Commission hearings; update interpreter requests related to continuations/rescheduling.

MINIMUM QUALIFICATIONS

Education: Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: One year of clerical experience handling compensation claims or three years of general clerical experience.

Notes:

1. Candidates may substitute additional general clerical experience on a year-for-year basis for the required education.

2. Candidates may substitute U.S. Armed Forces military service experience as a non-commissioned officer in Workers’ Compensation Claims Examining classifications or Workers’ Compensation Claims Examining specialty codes in the Legal and Kindred field of work on a year-for-year basis for the required experience. 

DESIRED OR PREFERRED QUALIFICATIONS

It is desired or preferred that candidates have:

1 year experience with workers’ compensation claims 

1 year experience working with insurance companies/agencies

LIMITATIONS ON SELECTION

This recruitment an INTERNAL ONLY recruitment and is limited to current employees of the Maryland Workers' Compensation Commission.

LICENSES, REGISTRATIONS AND CERTIFICATIONS

NOT APPLICABLE.

SELECTION PROCESS

The examination will consist of a rating of the training and experience provided with your application. Submission with your application of a resume is strongly recommended. Please make sure that you provide sufficient information on your application to show that you meet the qualifications for this recruitment. All information concerning your qualifications must be submitted by the closing date. We will not consider information submitted after this date. Successful candidates will be ranked as Best Qualified, Better Qualified, or Qualified and placed on the employment (eligible) list for at least one year.

BENEFITS

FURTHER INSTRUCTIONS

If you are unable to apply online, or encounter difficulty attaching documentation, you may submit via mail or deliver in person. Please be sure to include your name, identification number (Easy ID#) and job announcement number (21-002218-0001) on any documentation to ensure timely processing.

PLEASE DO NOT FAX OR EMAIL UNSOLICITED DOCUMENTATION
Please include your completed employment application.

Completed application and supportive documentation, may be mailed to: 

MD Workers' Compensation Commission 
Attn: Personnel Department 
7th floor 10 E. Baltimore Street 
Baltimore, MD 21202 

For information regarding this recruitment, please email wccpers@wcc.state.md.us or contact 410-864-5230. 

As an equal opportunity employer, Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity. 

People with disabilities and bilingual candidates are encouraged to apply. We thank our Veterans for their service to our country. 

TTY Users: call via Maryland Relay



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