Compensation Claims Analyst

Department

Department of Labor And Training

Division

Regulatory Compliance

Salary

$57,806.00 - $65,606.00

Job Profile

JC-02536600-27 - Compensation Claims Analyst (C94 L2869 DOA DLT)

Scheduled Work Days & Work Hours

Monday - Friday; 8:00 AM - 3:30 PM.

Position is within the Department of Labor & Training/Workers' Compensation.

Standard 35.0 hours.

Restricted/Limited to the leave of the prior incumbent.

Job Requisition Number

JR103858 COMPENSATION CLAIMS ANALYST (Open)

Pay Grade

C00322 A

Classification

Compensation Claims Analyst

Class Definition

GENERAL STATEMENT OF DUTIES: To be responsible for examining personal injury reports and claims, as well as settlement agreements relative to personal injuries arising out of and in the course of employment, for the purpose of determining compliance with the provisions of the Workers' Compensation Act; to be responsible for reviewing and verifying workers' compensation computer data reports and to compile statistical data, survey information and reports on various other claim matters for utilization by the Department; and to conduct training classes for adjusters, examiners, and self-insured in Workers' Compensation procedures as per law and department rules and regulations; and to do related work as required.

SUPERVISION RECEIVED: Works under the general supervision of a superior with latitude in the exercise of initiative and independent judgement; work must be in compliance with departmental policies, rules, regulations, and provisions of the Act.

SUPERVISION EXERCISED: Reviews for accuracy and compliance, both in process and upon completion the work of a professional, licensed staff of insurance claims examiners and adjusters in private industry engaged in processing claims for compliance's with the Act.

ILLUSTRATIVE EXAMPLES OF WORK PERFORMED:

• To be responsible for examining personal injury reports, claims as well as settlement agreements relative to personal injuries arising out of and in the course of employment, for the purpose of determining compliance with the provisions of the Workers' Compensation Act; and to be responsible for reviewing and verifying workers' compensation computer data and reports and to compile statistical data, survey information and reports on various other claim matters for utilization by the Department, including Cost of Living Adjustments and other changes ongoing in the Act.
• To be responsible for verifying and/or determining the payments of benefits, compensation, and other related services rendered to the injured claimant.
• To have the ability to understand and retain present and past laws regulating workers' compensation, and to keep abreast of rulings which impact the current statute.
• To provide technical advice and assistance to all parties involving their rights and obligations under the Workers' Compensation Act.
• To provide both routine and technical information to the general public and professional community regarding their rights and responsibilities.
• To conduct both informal and formal training seminars, in the office, on the telephone, and outside the office, instructing persons as to the proper procedures in completing forms, the report form filing process, changes in the law, and other related information.
• To understand and record the paperwork initiated by the Workers' Compensation Court.
• To be responsible for the establishment and maintenance of an effective record-keeping system for assigned claimants and their compensation payments.
• To operate data entry equipment, as required.
• To do related work as required.

REQUIRED QUALIFICATIONS FOR APPOINTMENT:

KNOWLEDGES, SKILLS AND CAPACITIES: A thorough knowledge of the provisions of the Workers' Compensation Act, and the ability to apply such knowledge in the examination of, or the preparation and processing of, workers' compensation injury reports and claims, as well as settlement agreements relative to injuries arising out of, or in the course of employment; a working knowledge of medical terminology as it related to injuries, occupational diseases and disabilities; the ability to compile, interpret and disseminate data, and to make sound decisions in applying the provisions of the Act; a working knowledge of data processing methods and techniques utilized in the processing of workers' compensation claims; the ability to communicate with all involved parties including injured workers, employers, insurance carriers, lawyers and other interested parties; and related capacities and abilities.

EDUCATION AND EXPERIENCE:

Education: Such as may have been gained through: graduation from a senior high school, supplemented by at least one year of higher education which included courses such as oral communication, accounting, and medical terminology; and

Experience: Such as may have been gained through: employment in a position involving the collection, analysis and evaluation of data relevant to the processing of workers' compensation benefits, insurance claims, or other similar areas of claim activity.

Or, any combination of education and experience that shall be substantially equivalent to the above education and experience.

Supplemental Information

GENERAL STATEMENT OF DUTIES: To be responsible for examining personal injury reports and claims, as well as settlement agreements relative to personal injuries arising out of and in the course of employment, for the purpose of determining compliance with the provisions of the Workers' Compensation Act; to be responsible for reviewing and verifying workers' compensation computer data reports and to compile statistical data, survey information and reports on various other claim matters for utilization by the Department; and to conduct training classes for adjusters, examiners, and self-insured in Workers' Compensation procedures as per law and department rules and regulations; and to do related work as required. SUPERVISION RECEIVED: Works under the general supervision of a superior with latitude in the exercise of initiative and independent judgement; work must be in compliance with departmental policies, rules, regulations, and provisions of the Act. SUPERVISION EXERCISED: Reviews for accuracy and compliance, both in process and upon completion the work of a professional, licensed staff of insurance claims examiners and adjusters in private industry engaged in processing claims for compliance's with the Act.

Benefits

For information regarding the benefits available to State of Rhode Island employees, please visit the Office of Employee Benefits' website at http://www.employeebenefits.ri.gov/.

Also, be advised that a new provision in RI General Law 35-6-1 was enacted requiring direct deposit for all employees. Specific to new hires, the law requires that all employees hired after September 30, 2014 participate in direct deposit. Accordingly, any employee hired after this date will be required to participate in the direct deposit system. At the time the employee is hired, the employee shall identify a financial institution that will serve as a personal depository agency for the employee.