Connecticut StateDepartment of Administrative Services

Claims Analyst

Recruitment #211227-0399AR-001

Introduction

 

The Office of the State Treasurer exists to provide and ensure effective financial management of public resources, high standards of professionalism and integrity, and expanding opportunity for State of Connecticut residents and businesses.

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.

We are recruiting for a Claims Analyst to work full-time, 40 hours per week in the Unclaimed Property and Second Injury Fund Division, located in Hartford, CT, with a Monday to Friday schedule.  NOTE:  Candidates are required to submit proof of current adjuster license. The incumbent will be required to travel, attend workers compensation hearings and manage a case load.

The Claims Analyst will be responsible for reviewing each request based on state law, any orders and/or memoranda issued by the Workers’ Compensation Commission (WCC) and documentation submitted in support of the request. They will then submit the request to the Claims Manager for review and submission to the Accounting unit for payment.

About the Second Injury Fund

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.  

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.   In addition, The Fund currently has almost 2,400 open claims and more than 2,800 Workers’ Compensation hearings annually. 

The Fund’s book of business has steadily changed over the years.  During the last several years, the Fund has been required to meet new Medicare quarterly reporting requirements which follow stringent guidelines; closely monitor claims for prescribed medications; monitor the legalization of medical marijuana in states where claimants live and determine the impact to The Fund; implement a new web-based computer system; and process the continuously increasing number of requests for reimbursement. 

Selection Plan

In order to comply with Public Act 21-69, the State of Connecticut is no longer asking for resumes during the initial application process.

After you apply:

This posting may require completion of additional referral questions (RQs). You can access these RQs via an email that will be sent to you after the posting's closing date or by visiting your JobAps Personal Status Board (Certification Questionnaires section). Your responses to these RQs must be submitted by the questionnaire's expiration date. Please regularly check your email and JobAps Personal Status Board for notifications. Please check your SPAM and/or Junk folders on a daily basis in the event an email provider places auto-notification emails in a user's spam.

  • Although applicants will receive correspondence via email, as a backup, they are also encouraged to sign on to their Personal Status Board on a daily basis to monitor their status, view all emailed notices and complete tasks required in the recruitment process.

  • At any point during the recruitment process, applicants may be required to submit additional documentation which support their qualification(s) for this position. These documents may include: a cover letter, resume, performance reviews, attendance records, supervisory references, licensure, etc., at the discretion of the hiring agency.

  • The immediate vacancy is listed above, however, applications to this recruitment may be used for future vacancies in this job class.

Communicating with us:

Due to the large volume of applications received, we are unable to provide confirmation of receipt or status during the recruitment process. Updates will be available through your JobAps portal account.  Interviews will be limited to candidates whose experience and training most closely meet the requirements of the position.  Candidates who are offered and accept a position with the State of Connecticut are bound by the State Code of Ethics for Public Officials and State Employees, which is available at www.ct.gov/ethics. 

Questions regarding this recruitment may be directed to Lorna Reid, lorna.reid@ct.gov.

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

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

  • Experience in case management of Worker's Compensation Claims
  • Must possess a current State of CT Worker's Compensation Casualty Adjuster License
  • Experience with case hearings preparation
  • Knowledge of medical terminology

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.



Click on a link below to apply for this position:

Fill out the Supplemental Questionnaire and Application NOW using the Internet.




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