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WCC CLAIMS ANALYST

Date:  Nov 21, 2022
Req ID:  24946
Location: 

Little Rock, AR, US, 72202

Category:  STATE INSURANCE DEPARTMENT
Anticipated Starting Salary:  39,696

Position Information

Class Code: G201C

Grade: GS05

FLSA Status: NON-EXEMPT

Salary Range: $32,405.00 - $46,987.00

Summary

The Workers' Compensation Commission (WCC) Claims Analyst is responsible for investigating and determining public employees' eligibility for Workers' Compensation benefits and authorizing the payment of benefits. This position is governed by state and federal laws and agency policy.

Functions

Investigates Workers' Compensation accident claims filed by public employees by reviewing submitted documentation, interviewing and documenting statements of claimants, supervisors, and witnesses to the accident, researching laws and related regulations, and obtaining medical information. Determines eligibility for Workers' Compensation benefits, submits case to supervisor for review and approval, and notifies all parties of determination. Files determination with Workers' Compensation Commission and maintains and reviews case files. Initiates payment of benefits and attorney's fees and audits medical providers' invoices for reasonableness and relationship to injury. Prepares settlements on disputed claims. Assists legal staff with litigation, if necessary, by providing attorneys with all case information and testifying at hearings. Provides technical assistance to employers by conducting training sessions explaining Workers' Compensation provisions, regulations, and procedures and answering specific questions. Identifies possible subrogation claims by investigating third party liability and initiating recovery procedures. Performs other duties as assigned.

Dimensions

Knowledge, Skills and Abilities

Knowledge of the Workers' Compensation Act and relating claims provisions and procedures. Knowledge of insurance claims processing procedures. Knowledge of supervisory practices and techniques. Ability to investigate, determine, and initiate payment of Workers' Compensation claims. Ability to prepare and present oral and written information and reports. Ability to interpret and explain Workers' Compensation provisions, procedures, and regulations. Ability to oversee the work of others.

Minimum Qualifications

The formal education equivalent of an associate’s degree in business management, office administration, health science, or a related field; plus three years of experience in processing insurance or other benefit claims or a related field.

Licenses


Nearest Major Market: Little Rock