Job description
Selection Plan
PURPOSE OF JOB CLASS (NATURE OF WORK)
In Department of Social Services, Offices of Policy and Management, State Comptroller, Treasurer and University of Connecticut this class is accountable for independently performing a full range of tasks in the examination of claims and supporting documentation for validity, legality and subsequent approval for payment.
EXAMPLES OF DUTIES
OFFICE OF THE TREASURER: Performs examination of second injury claims; verifies claimant medical history, date of injury, anatomical part injured, circumstances of injury and insurance carrier financial responsibilities; determines validity of base rates for payments and performs calculations; computes cost of living adjustments; prepares payments to health providers; maintains filing system for cases; contacts attorneys, physicians, health providers and insurance representatives regarding claims; may make recommendations for investigations to supervisor; may provide technical assistance and/or training to new or lower level employees; performs related duties as required.
CLAIMS EXAMINER: Under the direction of the Claims Supervisor, utilize technology and considerable due diligence to carefully process claims for Unclaimed Property using online system. Review complex documents that may include court and probate documents, probate documents, business and corporation documentation, finders' contracts, power of attorney, trust documents, bankrupticies, class filings, personal data and more for authenticity in support of claims utilizing UCP Guidelines, state law, and stanadardized workflows. Draft communications with claimants and colleagues. May communicate with claimants. Modify correspondence as necessary.
KNOWLEDGE, SKILL AND ABILITY
Knowledge of relevant state laws and regulations; knowledge of recordkeeping procedures; interpersonal skills; oral and written communication skills; skill in performing arithmetical computations; ability to read, understand and apply laws and regulations; ability to examine and analyze claims.
OFFICE OF THE TREASURER: knowledge of medical terminology; some knowledge of human anatomy.
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Four (4) years of experience in financial record keeping, accounting, purchasing, or claims processing.
MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED
College training may be substituted for the General Experience on the basis of fifteen (15) semester hours equalling one-half (1/2) year of experience to a maximum of two (2) years.
PREFERRED QUALIFICATIONS
- Minimum of two years of experience drafting, preparing and sending letters or responses to customers, personnel, or claimants' requests for additional information or relaying information or denials about related matters.
- Demonstrable attention to detail.
- Proven track record of learning new tasks and independently and efficiently completing complex work. Proven experience using and retrieving information from complex databases such as Core, KAPS, Microsoft Office applications, or SalesForce.
- Experience independently reading, interpreting and appropriately applying particular guidelines and internal controls while processing and approving claims.
- Two or more years' experience independently processing claims or similarly complex processes for legitimacy, compliance with rules, regulations, state laws, and applying office policies to either approve or deny claims.
- A minimum of six months' satisfactory experience independently reviewing documents (ex. corporate subsidiary listings, trusts, wills, power of attorney, beneficiary or custodial accounts, estate, conservatorship or guardianship documents from Probate Court, divorce decrees, third-party contracts, bankruptcy documents, healthcare claims, or similarly complex documents) submitted for a claim.
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