Claims Examiner

3 weeks ago

Montpelier, Vermont, United States State of Vermont Full time
Job Summary

This is a highly technical role that involves managing claims of workplace injury in the Department of Labor.

Key Responsibilities
  • Review and analyze various types of workers' compensation claims, including temporary partial disability, temporary total disability, permanent partial disability, and dependent benefits
  • Ensure compliance with regulatory requirements regarding payment rates, periods of payment, changes in rate, discontinuances of payment, and timely filing of required submissions
  • Communicate with stakeholders, including employers, claimants, carriers, and attorneys, to provide information and resolve issues
  • MEDATE_PRE_DISPUTE_PROBLEMS_BY_PHONE_EMAIL_AND_LETTER_IN_THE_INTEREST_OF_AVOIDING_FORMAL_DISPUTE
Requirements

This role requires the ability to gain expert knowledge of records management principles and procedures, as well as the use of a public records submission portal, bespoke claims management database, and multiple communications and scheduling platforms.

The incumbent must be skilled in dispute resolution and customer service, remaining both tactful and firm in attempts to secure proper claim resolution.

They must also be able to communicate professionally with individuals who are emotionally upset, resistant to or unfamiliar with the process, or disputatious.

Education and Experience

Minimum qualifications include a high school diploma or equivalent and two years at or above a senior clerical level of responsibility, including one year of direct interaction with and/or service to the public or other organizations.

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