Claims Examiner

Under the leadership of Connecticut’s State Treasurer Shawn T. Wooden, the Office of the Treasurer (OTT) is dedicated to safeguarding the state’s financial resources and taxpayers’ dollars, while maximizing returns, minimizing risks and operating at the highest professional and ethical standards. Through investments and disbursements, the Office continues to enhance the State’s fiscal stability, financial literacy, college savings, and its approach to leveraging business partnerships to combat social issues such as gun violence, climate change, and equal opportunity in economic growth that impact shareholder value.

We are accepting applications for the position of Claims Examiner.  This full-time, (40 hours per week, Monday-Friday), position is located in Hartford, CT, and offers a competitive benefits plan that includes healthcare coverage, a retirement plan, as well as, paid time off!  https://portal.ct.gov/DAS/smART/General-Employee-Benefits.

Applicants invited to interview may be required to submit additional documentation, which supports their qualification(s) for this position.  These documents may include:  resume, cover letter, three writing samples and 3-5 references.  In addition, performance reviews, supervisory references, college transcripts, licensure, etc., may also be requested, at the discretion of the hiring agency. 

Should you have questions pertaining to any phase of this recruitment, please contact the hiring agency's human resources office: lorna.reid@ct.gov.

NOTE:  All State employees shall follow the guidelines as listed in Executive Orders  13F (3a) and 13G (3a) .

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.

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.

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.

Four (4) years of experience in financial record keeping, accounting, purchasing, or claims processing.

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.

• Four years of experience processing claims for legitimacy, compliance with rules, regulations, state laws, applying office policies either approving or denying claims.
• A minimum of four years experience drafting, preparing and sending letters to customers detailing requests for additional information or denial of claim.
• Experience in independently reading, interpreting and applying office guidelines and internal controls while processing and approving claims.
• A minimum of four years experience with reviewing documents submitted for a claim.  Examples of documents to be reviewed include, but are not limited to, corporate subsidiary listings, trusts, wills, power of attorney, beneficiary or custodial accounts, estate, conservatorship or guardianship documents from Probate Court, divorce decrees or third-party contracts. 

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.