This information is for reference only. These classifications are no longer valid and were replaced 7/1/2020.
This is senior-level supervisory and technical work in the Missouri Division of Workers' Compensation coordinating the operations of a section responsible for program activities relating to securing and evaluati ng information required for the processing of Claims for Compensation, First Reports of Injury, and ancillary documents.
Applicants must meet one of the following eligibility requirements:
(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.)
One or more years of experience as a Workers' Compensation Technician III with the Missouri Division of Workers' Compensation; and possession of a high school diploma or proof of high school equivalency.
OR
Six or more years of technical experience processing and analyzing workers' compensation or insurance claims including two or more years of supervisory responsibilities; and possession of a high school diploma or proof of high school equivalency.
(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 general experience at a rate of 30 earned credit hours, or 480 clock hours per year.)
(Earned credit hours from an accredited college or university with specialization in Business or Public administration, or a closely related area may substitute on a year-for-year basis for the required general experience at a rate of 30 earned credit hours for one year.)
This description may not include all of the duties, knowledge, skills, or abilities associated with this classification.
Supervises and coordinates, through lower-level supervisors, technical staff engaged in the processing and oversight of case management duties for the Care Unit of the Missouri Division of Workers' Compensation.
Coordinates section workflow and operations; coordinates the quality assurance program; participates in the development of new policies and procedures due to rule, statute, or procedural changes; and compiles production reports.
Provides technical and administrative assistance to Workers' Compensation Technician III's who oversee the work of technical and clerical staff involved in claimant eligibility matters, bankruptcy issues, issues regarding separation from work, and interpretations of rules, regulations, and statutes.
Evaluates work from staff in order to ensure efficiency and uniformity of operations; coordinates units engaged in claims activities; and interprets and develops procedures for the application rules and regulations.
Reviews and compiles staff statistical reports to verify status and adjust workload to maintain productivity.
Coordinates, assigns, and provides section training on agency procedures, rules, laws, and regulations.
Reviews all relevant data needed in order to proceed with the adjudication of cases; requests additional information; and/or requests corrections be made to existing case files.
Oversees the division's Automated Integrated Claims database management system (AICS); develops and manages AICS business rules.
Initiates and completes cases in the event of any possible fraudulent activity; resolves complex case processing with the division's legal section.
Compiles and analyzes the quality of the information on legal and ancillary documents processed by staff; prepares reports for review by management and other staff; and develops and implements new procedures to facilitate the injury processing function.
Serves as liaison with other Division units and programs as well as the local adjudication offices.
Receives general supervision from a manager or administrative supervisor who interprets policy and procedures, and evaluates the efficiency of the operation and the attainment of program objectives.
Performs other related work as assigned.
Comprehensive knowledge of state laws and regulations governing the processing and adjudication of Workers' Compensation cases, claims handling, and programs.
Comprehensive knowledge of the policies, procedures, and operations of the Division of Workers' Compensation.
Comprehensive knowledge of the computer systems utilized in the Division of Workers' Compensation.
Comprehensive knowledge of relational database case management applications.
Comprehensive knowledge of Workers' Compensation claims processing.
Comprehensive knowledge of office practices, procedures, equipment and desktop computer applications.
Comprehensive knowledge of basic legal and medical terminology .
Intermediate knowledge of the principles of supervision and training.
Intermediate knowledge of basic bookkeeping and accounting principles and practices.
Intermediate knowledge of the principles of personnel, business, and office management.
Ability to identify critical issues that must be corrected or redesigned.
Ability to exercise considerable initiative and judgment in planning and carrying out assignments.
Ability to organize work activities to achieve established goals and objectives.
Ability to make decisions in accordance with established guidelines.
Ability to provide administrative and technical advice and training to staff in order to expedite casework.
Ability to work with electronically submitted data on a variety of databases.
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 claims.
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 establish and maintain effective working relationships with other employees, customers, attorneys, insurers, health care providers, prosecutors, law enforcement officials and the public.