- Workers' Compensation Technician I
- What will I be doing?
- Do I qualify?
- Can I be successful?
- How do I apply?
This is entry-level technical work in the Care Unit of the Missouri Division of Workers' Compensation involving securing and evaluating basic information required for processing Claims for Compensation, First Reports of Injury, and ancillary documents.
Secures, reviews, evaluates, and processes Claims for Compensation, First Reports of Injury, medical reports, lost wage reports, Answers to Claims, and Entries of Appearences by attorneys for non-contested and less complex claims.
Identifies documents that are incomplete and requests new or additional information to prepare claims for possible adjudication.
Identifies potential non-compliance reporting issues in accordance with statutes and regulations; works with the Workers' Compensation Technician III and Supervisor to process this information.
Reviews Electronic Data Interchange (EDI) documents after the pre-run is completed by the Workers' Compensation Technician II to identify deficiencies and return for correction.
Communicates with insurance companies, third party administrators, and self-insured employers using standardized letters.
Applies established procedures to evaluate the payment of lost wages; notifies insurer when incorrect amount has been paid and requests correction; and enters confirmed wage into Automated Integrated Claims System (AICS) database.
Corresponds and communicates with attorneys, insurance carriers, employers, third party administrators, and injured employees to facilitate the processing of reports and claims.
Notifies the insurer, third party administrator, or employer of over or underpayment of benefits and assists with the resolution of lost wage payment discrepancies.
Receives and answers telephone calls and written inquiries regarding workers' compensation claims.
Establishes, maintains, and purges files for less complex claims; identifies document types and scans and indexes those documents to the underlying workers' compensation case file.
Attends various training sessions and meetings to become and remain aware of program procedures and law changes; studies Workers' Compensation statutes, regulations, policies, and procedures.
Receives close supervision and mentoring to develop skills ; however, the employee is expected to exercise independent judgment and initiative within the framework of established state laws, regulations, policies, and procedures.
Performs other related work as assigned.
(The following minimum qualifications will determine merit system eligibility. Allowable experience and education substitutions are provided in italics below the corresponding minimum qualification statement. These minimum qualifications may also be used to evaluate applicants for Missouri Uniform Classification and Pay System positions not requiring selection from merit registers.)
Two or more years of clerical or related office experience with the Missouri Division of Worker's Compensation; and possession of a high school diploma or proof of high school equivalency.
Three or more years of clerical or general office support experience; and possession of a high school diploma or proof of high school equivalency.
(Post secondary training from an accredited vocational or business school in Office Management, Secretarial Science, or a closely related area may substitute on a year-for-year basis for a maximum of one year of the required experience at a rate of 30 earned credit hours, or 480 clock hours, for one year.)
(Earned credit hours from an accredited college or university may substitute on a year-for-year basis for the required experience at a rate of 30 earned credit hours for one year.)
Please note that documentation that supports your eligibility (i.e. transcripts, employment records, etc.) may be required at any time during the application and hiring process. If you do not possess the minimum qualifications, please consider one of many other employment opportunities with the State of Missouri.
Do you possess the key skills which are considered essential for successful employment in this classification?
Introductory knowledge of state laws and regulations governing the processing and adjudication of Workers' Compensation claims.
Introductory knowledge of the policies, procedures, and operations of the Division of Workers' Compensation.
Introductory knowledge of the computer systems utilized in the Division of Workers' Compensation.
Introductory knowledge of relational database case management applications.
Introductory knowledge of basic claims processing.
Introductory knowledge of basic legal and medical terminology .
Introductory knowledge of office practices, procedures, equipment, and desktop computer applications.
Introductory knowledge of basic bookkeeping and accounting principles and practices.
Ability to obtain and document relevant claim information clearly and concisely, evaluate information, and make determinations based on established policies and procedures.
Ability to work with electronically submitted data on a variety of databases.
Ability to compile relevant case information independently.
Ability to exercise sound judgment in the analysis of case information in order to expedite legal compliance issues and reduce delay in case adjudication.
Ability to explain and apply rules, regulations, and policies governing the processing of Workers' Compensation Injury claims.
Ability to perform mathematical calculations with speed and accuracy.
Ability to work rapidly and accurately in processing a large volume of documents.
Ability to communicate effectively and prepare clear and concise reports.
Ability to make routine decisions in accordance with established guidelines.
Ability to establish and maintain effective working relationships with other employees, employers, attorneys, insurance companies, and third party administrators.
The following link will provide you with general information about State of Missouri employee benefits.View benefits