UNIT CLAIMS MANAGER

Department

Department of Labor And Training

Division

Regulatory Compliance

Salary

$65,836.00 - $76,037.00

Job Profile

JC-02534500-27 - Unit Claims Manager

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.

Job Requisition Number

JR103363 UNIT CLAIMS MANAGER (Open)

Pay Grade

C00326 A

Classification

Unit Claims Manager

Class Definition

GENERAL STATEMENT OF DUTIES: To plan, direct and coordinate the work of a staff of claims examiners engaged in the examination of, or preparation and processing of, Reports of Injury, Agreements of Settlement, Suspension Agreements, Workers' Compensation and Sick Leave Schedules, and other forms, reports and/or schedules thereof relative to injuries arising out of, and in the course of, industrial employment or state employment in accordance with the provisions of the Workers' Compensation Act; and to do related work as required.

SUPERVISION RECEIVED: Works under the direction of a superior with wide latitude for the exercise of initiative and independent judgement; work is reviewed occasionally for effectiveness and conformity.

SUPERVISION EXERCISED: Plans, directs and coordinates the work of a staff of technical and clerical employees.

ILLUSTRATIVE EXAMPLES OF WORK PERFORMED:

• To plan, direct and coordinate the work of a staff of claim examiners engaged in the examination of, or preparation and processing of, Reports of Injury, Agreements of Settlement, Suspension Agreements, Workers' Compensation and Sick Leave Schedules and other forms, reports and/or schedules thereof relative to injuries arising out of, and in the course of, industrial employment or state employment in accordance with the provisions of the Workers' Compensation Act.
• To make assignments and to review work performance of subordinates for compliance with regulations, work standards, and compliance with the Workers' Compensation Act.
• To review staff and medical reports, and to determine when to continue weekly payments, when to initiate action to reduce or discontinue payments, and when to prepare cases for legal action.
• To design systems to expedite the payment of various claims.
• To maintain and prepare various financial records and documents, including proposed budgets, deficiency appropriation requests, and expenditure records.
• To research various problems which arise in connection with claims and to prepare decisions on certain cases.
• To interpret and apply the provisions of the Workers' Compensation Act and related acts, and analyze rulings and decisions of the state courts and other jurisdictions in this area.
• To assist injured workers, lawyers, business representatives and employers in understanding and functioning under the program.
• 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 supervision of a staff of claims examiners; a working knowledge of medical terminology as it relates to injuries, occupational diseases, disabilities and rehabilitation processes and techniques; the ability to review staff and medical reports in order to make decisions through the interpretation of the Workers' Compensation Act; the ability to maintain and prepare various financial reports and records; the ability to assist injured workers, lawyers, business representatives, employers and others in understanding and functioning under the program; the ability to establish and maintain effective working relationships with officials, subordinates, employers, employees and the general public; and related capacities and abilities.

EDUCATION AND EXPERIENCE:

Education: Such as may have been gained through: graduation from a college of recognized standing with specialization in business administration, management, economics or other related fields; and

Experience: Such as may have been gained through: employment in a responsible position involving a claims processing program such as workers' compensation, unemployment compensation, negligence claims, insurance claims, or other comparable claims processing programs.

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 plan, direct and coordinate the work of a staff of claims examiners engaged in the examination of, or preparation and processing of, Reports of Injury, Agreements of Settlement, Suspension Agreements, Workers'' Compensation and Sick Leave Schedules, and other forms, reports and/or schedules thereof relative to injuries arising out of, and in the course of, industrial employment or state employment in accordance with the provisions of the Workers'' Compensation Act; and to do related work as required. SUPERVISION RECEIVED: Works under the direction of a superior with wide latitude for the exercise of initiative and independent judgement; work is reviewed occasionally for effectiveness and conformity. SUPERVISION EXERCISED: Plans, directs and coordinates the work of a staff of technical and clerical employees.

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.