Connecticut StateDepartment of Administrative Services

Claims Analyst

Recruitment #191219-0399AR-001

Introduction

The State of Connecticut Office of the State Treasurer seeks qualified individuals for up to two Claims Analyst positions within their Second Injury Fund Department. The Second Injury Fund ("SIF" or "the Fund") is a state operated workers' compensation insurance fund established in 1945 to discourage discrimination against veterans and encourage the assimilation of workers with a pre-existing injury into the workforce. Public Act 95-277 closed the Fund to new "second injury" claims for injuries sustained on or after July 1, 1995 and expanded enforcement, fines and penalties against employers who fail to provide workers' compensation coverage. Prior to July 1, 1995, the Fund provided relief to employers where a worker, who already had a pre-existing injury or condition, was hurt on the job and that second injury was made "materially and substantially" worse by the first injury (thus the term "Second Injury Fund"). Such employers transferred liability for these workers' compensation claims to the Fund, if certain criteria were met under the Connecticut Workers' Compensation Act. Today the Fund continues to be liable for those claims transferred prior to the closing of the Fund as well as claims involving uninsured employers, reimbursement of cost of living adjustments for certain injuries involving payment of total disability benefits or dependent widow's benefits and, on a pro rata basis, reimbursement claims to employers of any worker who had more than one employer at the time of the injury. The Fund seeks to provide quality service both to the injured workers and employers of Connecticut, whom it jointly serves and accomplishes this by adjudicating qualifying workers' compensation claims fairly and in accordance with applicable law, industry standards and best practices. Where possible, the Fund seeks to return injured workers to gainful employment or seeks settlement of claims, which ultimately reduces the burden on Connecticut taxpayers and businesses. 

These positions are 40 hours per week, Monday through Friday. Applicants will be required to travel, attend workers compensation hearings and manage a case load. 

Please note, in order to qualify for this opportunity, you must be in possession of and submit proof of current adjuster license. 

All applicants must include a resume within the "Resume Tab" of their application with their submission.  Please Note: You will be unable to make revisions once you submit your application for this posting to the JobAps system.

Should you have questions pertaining to this recruitment, please contact Ronnell Young, at ronnell.young@ct.gov or (860)702-3144.

 

Selection Plan

This position will be filled in accordance with reemployment, SEBAC, transfer, promotion and merit employment rules.

Applicants invited to interview may be required to submit additional documentation, which supports their qualification(s) for this position.  These documents may include:  performance reviews, supervisory references, college transcripts, licensure, etc., at the discretion of the hiring agency.

PURPOSE OF JOB CLASS (NATURE OF WORK)

In the Office of the State Treasurer, this class is accountable for independently performing a full range of professional tasks in the review and analysis of workers’ compensation claims and coordination of other related program activities.

EXAMPLES OF DUTIES

Reviews legal and medical documentation relevant to pending workers’ compensation claims to determine liability and/or eligibility; acts as liaison between attorneys, insurance carriers and others to obtain information necessary to determine liability, eligibility and/or compensability; analyzes claim information and identifies issues regarding liability and/or eligibility; monitors cases to ensure accuracy of continued benefit; recalculates benefit payments to determine accuracy of amounts and duration; determines action plan to facilitate employee return to work or settlement of claim; negotiates settlements; identifies and works to recover payments; prepares demand letters and liens; processes requests for reimbursement from carriers and self-insurers for payments made to claimants; submits recommendations on claim transferability or contested liability to Special Funds Administrator; drafts transfer agreements; schedules pre-hearing conferences on contested transfer claims; assists Office of the Attorney General in case hearing preparation; prepares files for transfer to Second Injury Fund Claims Examination Unit; assists in establishment of policies and procedures; trains new employees as necessary; may represent, attend or assist in preparation of informal or formal hearings; performs related duties as required.

KNOWLEDGE, SKILL AND ABILITY

Considerable knowledge of and ability to interpret and apply workers' compensation statutes and regulations; knowledge of medical terminology; considerable oral and written communication skills; interpersonal skills; ability to read, understand and interpret legal documents and other written materials; ability to utilize computer software.

MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE

Six (6) years of experience in the case management of workers' compensation claims.

MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED

  1. College training may be substituted for the General Experience on the basis of fifteen (l5) semester hours equalling one-half (l/2) year of experience to a maximum of four (4) years for a Bachelor's degree.
  2. Certification as a Workers' Compensation Claims Law Associate (WCCLA) may be substituted for 2 (two) years of the General Experience.
  3. Possession of a current State of Connecticut Workers' Compensation Casualty Adjuster License may be substituted for one (1) year of the General Experience.

PREFERRED QUALIFICATIONS

Preferred candidates will be able to:

• Review pending workers compensation claims for liability and or eligibility;

• Monitor cases to ensure accuracy of continued benefits;

• Calculate benefit payments;

• Develop action plan for case closure;

• Process reimbursement requests;

• Analyze subrogation potential.

Candidate's must have a current adjuster license.

Conclusion

AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER

The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.







The State of Connecticut is an Affirmative Action/Equal Opportunity Employer and strongly encourages the application of women, minorities and persons with disabilities.