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ADMINISTRATIVE SPECIALIST II

Internal Only

Recruitment #22-001756-0006

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Introduction

This is an internal only recruitment for the Support Services Division of the Maryland Workers' Compensation Commission.  It is limited to current employees at the Commission.

GRADE

11

LOCATION OF POSITION

10 E Baltimore St.
Baltimore, MD 21202

POSITION DUTIES

This position assists the Workers’ Compensation Commission by coordinating the work of the Maryland Workers’ Compensation Registration Service Practitioner and Provider Program/Medical/Voc Rehab (MCRSP) and in conjunction working with the Medical Coding Specialist position processing medical claims for service submitted by approved medical practitioners; in accordance with rules and regulations set forth in COMAR 14.09.08.01;14.09.07.11.

Process/update Order Nisi, Final Order Nisi or Denial of additional payment for services letters as required; process vocational rehabilitation orders or denial letters after vocational rehabilitation plans are reviewed.

Review and approve new vocational rehabilitation practitioner applicant and renewal applicant applications based on Workers’ Compensation rules and regulations to determine if candidates are appropriate to become approved vocational rehabilitation practitioners and processes applications accordingly. 

Establish and maintain a system for timely processing of registration and renewal of registration files in accordance with Workers’ Compensation rules and regulations, and other licensing or certifying boards. 

Perform data entry in and maintain the database for tracking practitioner credentialing and re-credentialing (CEU) information. Research and verify provider credential documentation through various sources, i.e., Maryland Board of Nursing.  Assemble all verified information and prepare files for storage or for presentation to the Commission for recommendation if not approving a registration.  Maintaining communications with provider offices, State Boards, and other entities to promote relationships imperative to process request for vocational rehabilitation practitioner status.  

Review and verify medical claim data (claims forms, CMS 1500 forms, EOB, or other related documents) for accuracy, completeness, and compliance by applying appropriate Workers’ Compensation regulations, policies, and procedures.   Analyze and interpret clinical documentation contained in medical documents submitted to WCC, applying the appropriate procedural codes (CPT Codes, ICD-9/10); research for relevant codes when necessary for claim processing and make recommendations for corrective actions.  Apply correct payments to medical claims for services for medical practitioners submitted by medical practitioners pursuant to the Medical Fee Guide.

Act as a liaison with public and private agencies regarding WCC claims for all medical services and rehabilitation document processing; provides information on registration status and medical claim status to persons and agencies according to regulations.  Answer inquiries regarding practitioner and provider registration status, and work with colleagues to ensure the accuracy of all files by tracking the expiration of licenses and continuing education information.

Oversee the work of trainees or interns per Director’s or Supervisor’s instructions; provide back up assistance to the Medical Coding Manager.

Research and compile data, as directed; enters codes and maintains data into automated information systems for monthly reporting requirements. Other related duties assigned, as necessary.

MINIMUM QUALIFICATIONS

Experience:   Three years of experience in administrative staff or professional work.

Notes:

1. Candidates may substitute the completion of 60 credit hours at an accredited college or university and one year of experience in administrative staff or professional work for the required experience.

2. Candidates may substitute U.S. Armed Forces military service experience as a non-commissioned officer involving staff work requiring regular use of independent judgment and analysis in applying and interpreting rules and regulations in accordance with agency laws and policies on a year-for-year basis for the required experience.

SELECTIVE QUALIFICATIONS

Candidates MUST have the following:

One year of working knowledge and comprehension of the workers’ compensation vocational rehabilitation provider credentialing process.

DESIRED OR PREFERRED QUALIFICATIONS

It is preferred candidates have the following qualifications

Have at least four years of working knowledge of relevant Federal, State and local laws and regulations governing workers’ compensation, American Medical Association (AMA) guidelines  as  they apply  to  workers’ compensation, and  Medical  and technical  terminology  used in  industrial  injury cases. 

Have at least two years of recently processing workers’ compensation medical claims.   

Experience in public sector environment is highly desirable. 

Have at least three years of working knowledge of Microsoft Excel

SPECIAL REQUIREMENTS

Candidates may be responsible for providing their own transportation as needed to access meetings, remote locations, and job destinations as assigned.

SELECTION PROCESS

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 eligible (employment) list for at least one year.

BENEFITS

FURTHER INSTRUCTIONS

If you have any questions about this recruitment, please contact the Workers' Compensation Commission at 410-864-5230.

TO APPLY: Please include your resume along with your completed online employment application.  During the online application process, use the Resume tab to select a method for including your resume (Upload Your Resume or Type or Copy/Paste Your Resume).  Submission of a resume is strongly recommended. 

If you are unable to apply online, or encounter difficulty attaching required or optional 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 on any documentation to ensure timely processing.  Please include your resume along with your completed employment application and supplemental questions. 

PLEASE DO NOT FAX OR EMAIL UNSOLICITED DOCUMENTATION Completed applications, required documentation, and any required addendums may be mailed to: 

Workers' Compensation Commission Attn: 22-001756-0006 
E. Baltimore Street, Personnel Division  
Baltimore, MD 21202 

TTY Users: call via Maryland Relay We thank our Veterans for their service to our country, and encourage them to apply. 

WCC is an equal opportunity employer. It is the policy of WCC that all persons have equal opportunity and access to employment opportunities, services, and facilities without regard to race, religion, color, sex, age, national origin or ancestry, marital status, parental status, sexual orientation, disability or veteran status. 

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



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