Department of Administrative Services

Claims Examiner (1979CL)

$22.38-$29.26 Hourly / $1,790.08-$2,340.85 BiWeekly /
$46,721.09-$61,096.19 Yearly


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.

SUPERVISION RECEIVED

Works under general supervision of an employee of higher grade.

SUPERVISION EXERCISED

May lead lower level employees as assigned.

EXAMPLES OF DUTIES

DEPARTMENT OF SOCIAL SERVICES: Examines invoices and supporting documentation for vendor services to agency clients provided under various community based service programs; ensures accuracy, completeness and conformance to state statutes, regulations and agency policy; obtains authorization for payment from agency officials; notifies social worker or other official of information changes requiring follow up with client or provider; contacts provider agencies to verify information necessary to issue payment; enters authorized payment amounts and other data in agency on-line eligibility system to produce vendor payments to providers; completes narrative field to document payments issued; prepares reports of case activity, payments, new cases and other program activity; investigates returned checks and reissues payments as appropriate.

OFFICE OF POLICY AND MANAGEMENT (Intergovernmental Relations Division): Reviews, processes and approves applications of statutory mandated reimbursement programs for payment; performs examinations and verification of source documents and records in Assessor, Tax Collector and Town Clerks offices and makes determinations for validity and approval of claims for reimbursement by the state; corrects and maintains roster file of these payments; provides information, counseling and referral services to claimants and general public; prepares analytic and audit reports and certifies claim amount to State Comptroller; performs related duties as required.

OFFICE OF STATE COMPTROLLER: Performs examinations of liabilities and expenditures of the State of Connecticut and makes determinations for validity, legality and approval of claims against state including personal service contracts, personal property leasing contracts, data processing maintenance and service agreements, leasing of real property, purchase orders for purchasing of equipment, commodities, emergency service and supplies, authorized travel reimbursement, construction projects as approved by State Bonding Commission and federal, state and private grants; corrects and maintains computer file of Taxable Miscellaneous Income; maintains control of balances of fixed liabilities; prepares analytical and audit reports; performs related duties as required.

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.

UNIVERSITY OF CONNECTICUT: Performs examinations of liabilities and expenditures and makes determination for validity, legality and approval of claims against University for personal service contracts, personal property leasing contracts, data processing maintenance and service agreements, purchasing of commodities, emergency service and supplies, authorized travel reimbursement and construction projects as approved by State Bonding Commission and federal, state and private grants; examines and maintains control of balance of fixed liabilities; responsible for maintaining disbursement records, distributing charges to proper accounts and encumbering appropriation accounts for purchase orders; insures expenditure plus encumbrances within appropriate limits; issues payments and monitors and reconciles analytical and audit reports utilizing University financial records system; calculates and applies discounts by monitoring vendor terms and dates; corrects and updates University vendor database; performs related duties as required.

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.

JOB CLASS DESIGNATION

Classified/Competitive

OCCUPATIONAL GROUP

(05)-Clerical/Secretarial

BARGAINING UNIT

(07)-ADMN CLERICAL (NP-3)

EEO

(6)-Administrative Support

SALARY INFORMATION

CL 16

CANCELLATION CLAUSE

This replaces the existing specification for the class of Claims Examiner in Salary Group CL 16 approved effective October 5, 2001. (2009 SCOPE Review)

EFFECTIVE DATE

5/26/2009

CLASS: 1979CL; EST: 11/29/1980; REV: 5/26/2009;