- Workers' Compensation Technician III
- What will I be doing?
- Do I qualify?
- Can I be successful?
- How do I apply?
This is entry-level supervisory and advanced technical work in the Care Unit of the Missouri Division of Workers' Compensation involving direct supervision of a unit responsible for securing and evaluating information required for the processing of Claims for Compensation, First Reports of Injury, and ancillary documents.
Provides immediate technical supervision to a unit of Workers' Compensation Technicians who process contested and non-contested Workers' Compensation cases; consults with the Workers' Compensation Technician Supervisor, program manager, or the Division legal advisor regarding complex case procedures; and acts as the problem solver for assigned work group.
Assists injured workers, attorneys, judges, and self-insurance manager when processing claims or investigating insurer or self-insured employer bankruptcy issues; corresponds with attorneys, insurance companies, third party administrators, and self-insured, self-administering employers to compile additional case information used to adjudicate the case.
Assigns work to lower-level technicians and acts as trainer for new employees who are not performing as expected; participates in trainings conducted for outer office employees, insurers, third party administrators, or self-insured, self-administering employers who must report to the Division.
Establishes and maintains Trading Partner Agreements with entities that report Workers' Compensation Case Information to the Division electronically; updates the agreements annually or as needed.
Investigates licensure issues related to insurance companies and third party administrators.
Investigates and prepares documentation for referral to Fraud and Non Compliance Unit with the assistance of the Workers' Compensation Technician Supervisor.
Identifies, with the assistance of the Workers' Compensation Technician Supervisor, issues that require intervention, consultation, or resolution from the Division Chief Legal Advisor.
Works with the Workers' Compensation Technician Supervisor to develop performance objectives and appraisals for Workers' Compensation Technicians.
Completes quality assurance reviews for data accuracy, determining if employees have correctly calculated the average week wage and lost time benefits, and have properly processed medical costs and records.
Assists with the development and update of new and existing standard operating policies and procedures.
Receives general supervision from a Workers' Compensation Technician Supervisor; however, the employee is expected to work independently in the performance of assigned responsibilities within established guidelines.
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.)
One or more years of experience as a Workers' Compensation Technician II with the Missouri Division of Workers' Compensation; and possession of a high school diploma or proof of high school equivalency.
Five 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.)
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?
Comprehensive knowledge of state laws and regulations governing the processing and adjudication of Workers' Compensation claims.
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 basic legal and medical terminology .
Comprehensive knowledge of office practices, procedures, equipment and desktop computer applications.
Intermediate knowledge of basic bookkeeping and accounting principles and practices.
Introductory knowledge of the principles of supervision and training.
Ability to provide technical direction to a unit of Workers' Compensation Technicians.
Ability to explain and apply rules, regulations, and policies governing the processing of Workers' Compensation First Reports of Injury and Claims for Compensation.
Ability to calculate lost wages and distinguish the differences in benefits and payment levels owed for temporary partial disability, temporary total disability, permanent partial disability, and permanent total disability.
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 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 establish and maintain effective working relationships with other employees, employers, attorneys, insurance companies, third party administrators, health care providers, judges, and insured workers.
The following link will provide you with general information about State of Missouri employee benefits.View benefits