New York State Insurance Fund (NYSIF) · 22 hours ago
Claims Services Representative Trainee 1 (NY HELPS)
New York, NY
Full-time
Onsite
Entry Level
$58K/yr - $73K/yr
4+ years expNew York State Insurance Fund (NYSIF) is seeking a Claims Services Representative Trainee 1. The role involves overseeing workers compensation claims processing, determining claim compensability, and managing payment and medical bill analysis.
ConsultingFinancial ServicesInsurance
No H1B
Responsibilities
Oversee all aspects of workers compensation claims processing from inception to closing
Initially determine the compensability of claims and file appropriate documentation with the Workers Compensation Board (WCB)
Calculate and adjust reserves consistent with case analysis over the anticipated life of the claim
Recommend cases for appeal to WCB
Negotiate and/or make recommendations regarding lump sum settlements
Issue payments and requests for reimbursement where claims for supplemental benefits are involved
Review awards to ensure the correct recipient and rate of compensation
Schedule or waive medical examinations as necessary
Analyze medical bills to determine causality, levels of treatment, necessity for treatment, appropriateness of fees and procedure codes, and apportionment status
Respond to requests for home modifications, home health care personnel, medication, and medical supplies and appliances
Review case activity and determine when a claim can be retired
Qualification
Required
Reachable on current Civil Service eligible list for this title; OR
One year of permanent, competitive class service in a title eligible for transfer under Section 70.1 of the Civil Service Law. Eligible titles include, but are not limited to: Investigator 1, Assistant Insurance Fund Services Representative, Program Aide; OR
Four years of experience processing Workers Compensation or Disability Benefits including Paid Family Leave claims
An associate degree may substitute for two years of experience; a bachelor's degree or higher may substitute for four years of experience
Benefits
Competitive Compensation.
Future Career Growth Potential.
Open and Supportive Team-Based Environment.
Plentiful Vacation, Personal, and Sick Leave Accruals.
Paid State and Federal Holidays.
Full Medical, Vision, and Dental.
Retirement Options.
Public Student Loan Forgiveness (PSLF).
Possibility of Telecommuting, Flextime, and Alternative Work Schedules.
Company
New York State Insurance Fund (NYSIF)
The New York State Insurance Fund (NYSIF) was established in 1914 as part of the original enactment of the New York State Workers’ Compensation Law.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Chad Loshbaugh
Chief Operating Officer for Business Services
Ken Radigan
Chief Risk Officer (CRO)
Recent News
GlobeNewswire
2024-04-07
GlobeNewswire News Room
2023-10-06
Company data provided by crunchbase