Workers' Compensation Claims Examiner

3 weeks ago

Tallahassee, Florida, United States My Florida Corp Defunct Full time
Job Summary

This is a highly responsible and professional position in the investigation, evaluation, and payment of workers' compensation claims handled by the Division of Risk Management. The Workers' Compensation Specialist conducts detailed investigations of workers' compensation claims submitted to Risk Management on state employees, applies the appropriate laws, and makes a determination of compensability. The Specialist evaluates medical reports, authorizes medical treatment, determines if rehabilitation is needed, authorizes compensation payments and settlements. The Specialist must calculate and maintain proper monetary reserves on claims and must recognize and pursue recoveries either through subrogation or the Special Disability Trust Fund. The Specialist handles workers' compensation claims that have been assigned to defense counsel by directing defense activity to conform to sound claims handling principles. The Specialist attends formal workers' compensation mediations and hearings when necessary. The Specialist assists and advises the Claims Coordinators of various state agencies, departments, divisions, bureaus, and sections with questions concerning workers' compensation claims, including but not limited to, questions of coverage, compensability, medical treatment, and reporting work-related accidents. As needed, the Specialist monitors the activities of Risk Management's prior service companies and timely and accurately completes all DWC forms necessary for Electronic Data Interchange Reporting. The Specialist performs other related work as required.

Responsibilities

* Conduct detailed investigations of workers' compensation claims submitted to Risk Management on state employees

* Apply the appropriate laws and make a determination of compensability

* Evaluate medical reports and authorize medical treatment

* Determine if rehabilitation is needed and authorize compensation payments and settlements

* Calculate and maintain proper monetary reserves on claims

* Recognize and pursue recoveries either through subrogation or the Special Disability Trust Fund

* Handle workers' compensation claims that have been assigned to defense counsel

* Direct defense activity to conform to sound claims handling principles

* Attend formal workers' compensation mediations and hearings when necessary

* Assist and advise the Claims Coordinators of various state agencies, departments, divisions, bureaus, and sections with questions concerning workers' compensation claims

* Monitor the activities of Risk Management's prior service companies and timely and accurately complete all DWC forms necessary for Electronic Data Interchange Reporting

* Perform other related work as required

Requirements

This position requires a bachelor's degree from an accredited college or university and one or more years of experience in the insurance field or six months of experience adjusting workers' compensation claims. The ideal candidate will have a Florida Adjuster License and at least one year of experience adjusting workers' compensation claims within the last three years. The candidate should also have at least one year of experience working in workers' compensation insurance claims business and at least one year working in workers' compensation insurance claims business in the State of Florida. Experience working with any risk management information systems and/or any software programs designed to assist adjusting workers' compensation claims is also preferred.

Working Conditions

This is a highly responsible and professional position that requires the ability to work independently and exercise a great deal of independent judgment. The Specialist will work under the general supervision of the Workers' Compensation Administrator and will be responsible for conducting detailed investigations of workers' compensation claims submitted to Risk Management on state employees. The Specialist will also be responsible for applying the appropriate laws and making a determination of compensability. The Specialist will work in a fast-paced environment and will be required to handle multiple tasks and priorities simultaneously.

Benefits

This position offers a competitive salary range of $46,548.00-$50,000.00, based upon experience. The position also offers a comprehensive benefits package, including health, dental, and vision insurance, as well as a 401(k) plan. The position also offers paid time off and holidays.

How to Apply

To apply for this position, please submit your application and resume to the People First Service Center. Please note that responses to qualifying questions must be clearly supported by the state application and any omission, falsification, or misrepresentation in the answering of the qualifying questions will be cause for immediate elimination from the selection process.

Equal Employment Opportunity

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer and does not tolerate discrimination or violence in the workplace. Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center.

Drug-Free Workplace

The State of Florida supports a Drug-Free workplace and all employees are subject to reasonable suspicion drug testing in accordance with Section , F.S., Drug-Free Workplace Act.

Veterans' Preference

Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans' Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.

Location

Tallahassee, FL, US, 32308

Nearest Major Market
Tallahassee

  • Claims Examiner

    4 weeks ago

    Tallahassee, Florida, United States Command Investigations Full time

    Job SummaryCommand Investigations is seeking a skilled Claims Investigator to join our team. As a Claims Investigator, you will be responsible for conducting thorough investigations of commercial and personal lines claims, gathering evidence, and interviewing witnesses to determine the facts of each case.Key ResponsibilitiesConduct investigations of...

  • Physician for Veteran Disability Examinations

    4 weeks ago

    Tallahassee, Florida, United States Vivo HealthStaff Full time

    Veteran Disability Examination OpportunitiesVivo HealthStaff Inc is seeking Physicians to conduct medical examinations for veteran disability claims at various locations across the United States.Key Responsibilities:Conduct thorough medical examinations to assess veteran disabilityHourly compensation with malpractice insurance includedRequirements:Active and...

  • Physician for Veteran Disability Examinations

    3 weeks ago

    Tallahassee, Florida, United States Vivo HealthStaff Full time

    Job Summary:Vivo HealthStaff Inc is recruiting for Physicians to conduct Veteran Disability Examinations at various locations across the United States.Key Responsibilities:Conduct thorough medical examinations for Veteran Disability claimsHourly pay with malpractice insurance includedRequirements:Active and unrestricted state medical licenseBoard...

  • Physician for Medical Disability Examinations

    3 weeks ago

    Tallahassee, Florida, United States BAS Healthcare Full time

    Job Opportunity: BAS Healthcare is seeking a skilled Internal Medicine Physician to conduct medical disability examinations and evaluations for the U.S. Department of Veterans Affairs. Key Responsibilities: Perform PRN-based medical exams on a variety of specialties, including family medicine, internal medicine, and orthopedic surgery.Conduct interviews and...

  • Audiology Specialist

    3 weeks ago

    Tallahassee, Florida, United States Trusted Medical, LLC Full time

    Job Title: AudiologistAbout the Role:This position supports the U.S. Department of Veterans Affairs in conducting assessments for Veterans leaving military service or applying for disability benefits from the VA. The Audiologist will apply their expertise in the evaluation and diagnosis of audio conditions to support a Veteran's disability claim with the...

  • Dental Services Provider

    3 weeks ago

    Tallahassee, Florida, United States State of Florida Full time

    Job SummaryWe are seeking a highly skilled and experienced Dental Services Provider to join our team at the State of Florida. As a Pediatric Dentist, you will be responsible for providing professional dental services to pediatric clients of the Leon County Health Department, Molar Express.Key ResponsibilitiesProvide dental services consisting of examination,...

  • Audiologist Specialist

    4 weeks ago

    Tallahassee, Florida, United States Dynamics ATS Organic Full time

    Job Title: AudiologistAt Dynamics ATS Organic, we are seeking a highly skilled Audiologist to join our team. As an Audiologist, you will play a critical role in supporting the U.S. Department of Veterans Affairs in conducting assessments for Veterans leaving military service or applying for disability benefits from the VA.Job Summary:This role requires the...

  • Medical Director

    4 weeks ago

    Tallahassee, Florida, United States Vivo HealthStaff Full time

    Opportunity OverviewVivo HealthStaff Inc is seeking skilled Physicians to conduct Veteran Disability Examinations at various locations across the United States.Key ResponsibilitiesConduct thorough medical examinations for Veteran DisabilityHourly compensation with malpractice insurance includedRequirementsActive and unrestricted state medical licenseBoard...

  • Physician Opportunity in Key West and Tallahassee

    4 weeks ago

    Tallahassee, Florida, United States BAS Healthcare Full time

    Job Opportunity for Medical ProfessionalsWe are seeking a highly skilled Internal Medicine Physician to join our team at BAS Healthcare in Key West and Tallahassee, Florida.Job SummaryThis is a PRN opportunity for a physician to conduct medical disability examinations and evaluations for the U.S. Department of Veterans Affairs. The ideal candidate will have...

  • Respiratory Therapist

    4 weeks ago

    Tallahassee, Florida, United States i4 Search Group Healthcare Full time

    Job SummaryWe are seeking a highly skilled Respiratory Therapist to join our team at i4 Search Group Healthcare. As a Respiratory Therapist, you will be responsible for delivering life-support, resuscitation, and various medical gases therapy to patients. You will work under the general supervision of the Respiratory Therapy Supervisor and will be expected...

  • Emergency Medicine Physician Opportunity with SCP Health

    3 weeks ago

    Tallahassee, Florida, United States SCP Health Full time

    Emergency Medicine Physician OpportunitySCP Health is seeking an Emergency Medicine Physician to join our team. This is a great opportunity to work in a fast-paced environment with a high volume of patients.Key Details:Volume: 56,000 annual volumeBeds: 266 beds (16 beds in the ED)Coverage:Physicians: 7a-7p, 9a-9p, 1p-1a, 7p-7aNPPA: 6:30a-6:30p and...

  • Emergency Medicine Physician

    4 weeks ago

    Tallahassee, Florida, United States SCP Health Full time

    Emergency Medicine Physician OpportunityWe are seeking an experienced Emergency Medicine Physician to join our team at SCP Health. This is a challenging and rewarding opportunity to work in a fast-paced environment, providing high-quality patient care and collaborating with a skilled team of healthcare professionals.Key Responsibilities:Provide emergency...

  • Respiratory Therapist

    4 weeks ago

    Tallahassee, Florida, United States i4 Search Group Healthcare Full time

    Job SummaryAs a Lead Respiratory Therapist, you will be responsible for delivering life-support, resuscitation, monitoring, and various medical gases therapy to patients. You will assist patients of all ages with acute and chronic illness in returning to a productive lifestyle through education and the application of various therapeutic modalities.Key...

  • Pediatric Dentist

    3 weeks ago

    Tallahassee, Florida, United States gpac Full time

    Pediatric Dentist Job DescriptionGPAC is a reputable recruitment company with over 30 years of experience in the dentistry industry. We are currently seeking a skilled and passionate Pediatric Dentist to join a well-established company in the field.Position Details:As a Pediatric Dentist, you will work alongside a team of experienced dental professionals and...

  • Family Medicine Physician

    4 weeks ago

    Tallahassee, Florida, United States BAS Healthcare Full time

    Opportunities with BAS Healthcare **Job Summary** We are seeking a skilled Family Medicine Physician to join our team as a Compensation and Pension Examiner. As a key member of our team, you will be responsible for conducting exams and assessments for veterans across the country. **Responsibilities** * Conduct Compensation and Pension exams and...

  • Emergency Medicine Physician Assistant Specialist

    4 weeks ago

    Tallahassee, Florida, United States SCP Health Full time

    Job OverviewSCP Health is a physician-led team of clinical and operational experts dedicated to revitalizing healthcare. We develop and utilize proven models of care, proprietary technology, and data-driven insights to accelerate progress in care delivery across healthcare organizations. Our clinical offerings span the entire continuum of care, from...

  • Emergency Medicine Physician Assistant

    3 weeks ago

    Tallahassee, Florida, United States SCP Health Full time

    SCP Health OpportunityWe are a physician-led team of clinical and operational experts, passionate about revitalizing healthcare. Our team crafts and utilizes proven models of care, proprietary technology, and data-driven insights to accelerate progress in care delivery across healthcare organizations.Job DetailsVolume: 56,000 annual volumeBeds: 266 beds (16...

  • Ophthalmic Care Specialist

    4 weeks ago

    Tallahassee, Florida, United States Integrity Placement Group Full time

    Job Summary:We are seeking a highly skilled Ophthalmic Technician to join our team at a luxury eyewear wellness center in Lakeworth, FL. As a key member of our team, you will be responsible for delivering exceptional patient care and service with professionalism and attentiveness.Key Responsibilities: Patient pre-testing and examination Inventory management...

  • Registered Nursing Program Coordinator

    5 hours ago

    Tallahassee, Florida, United States MyFlorida Full time

    About the RoleWe are seeking a highly skilled Registered Nursing Program Coordinator to join our team at MyFlorida. As a key member of our healthcare team, you will play a vital role in ensuring the success of our Breast and Cervical Cancer Early Detection Program.Job DescriptionThe Registered Nursing Program Coordinator will be responsible for reviewing and...

  • Medical Assistant

    4 weeks ago

    Tallahassee, Florida, United States Dermatology Solutions Group Full time

    Job Title: Medical AssistantJoin Dermatology Solutions Group as a Medical Assistant and contribute to delivering exceptional patient care and experiences.Key Responsibilities:Assist Medical Providers with day-to-day delivery of healthcare and patient care management.Ensure correct and complete patient information in the health record by accurate...