In the Offices of Policy and Management (Intergovernmental Policy Division), State Comptroller, Treasurer and the Department of Social Services this class is accountable for supervising Claims Examiners and Associate Claims Examiners or clerical claims staff engaged in examining claims and supporting documentation for validity, legality and subsequent approval for payment.
Receives general direction from an employee of higher grade.
Supervises Claims Examiners, Associate Claims Examiners and other staff as assigned.
EXAMPLES OF DUTIES
Schedules, assigns, oversees and reviews work of staff;
Provides staff training and assistance;
Conducts performance evaluations;
Determines priorities and plans unit work;
Establishes and maintains unit procedures;
Develops or makes recommendations on development of policies and standards;
Acts as liaison with other operating units, agencies and outside officials regarding unit policies and procedures;
Prepares reports and correspondence;
Coordinates and supervises processing of all claims filed with utilizing state agency;
Reviews, analyzes and evaluates compensability of claims;
Determines need for further investigation;
Issues disclaimer notices on claims not considered compensable;
Reviews and evaluates all substantiating documentation;
Reviews and approves payment of claims;
Represents state at hearings;
Answers all inquiries pertaining to claims;
May review and approve for payment all medical bills submitted under compensation claims;
May establish specific indemnity involving percentage of loss of functions attributable to compensable injury;
May review for state recovery purposes all claims for third party action involving injuries covered under Second Injury and Compensation Assurance Fund and Criminal Injuries Compensation Account;
Performs related duties as required.
KNOWLEDGE, SKILL AND ABILITY
Considerable knowledge of
relevant agency policies and procedures;
relevant state and federal laws, statutes and regulations;
office systems and procedures;
oral and written communication skills;
Ability to utilize computer software;
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Six (6) years of experience in processing or investigating claims.
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 four (4) years for a Bachelor's degree.
JOB CLASS DESIGNATION
(16)-ADMIN & RESID (P-5)
As defined by Sec. 5-196 of the Connecticut General Statutes, a job class is a position or group of positions that share general characteristics and are categorized under a single title for administrative purposes. As such, a job class is not meant to be all inclusive of every task and/or responsibility.
This replaces the existing specification for the class of Claims Supervisor in Salary Group AR 21 approved effective February 15, 2012. (Revised to modernize format and add Acknowledgement section) Final No. 23-138