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Uninsured Employer Fund(UEF) Specialist

Administrative Officer I

Recruitment #26-002711-0029

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Introduction


Reimagine a career in public service. At WCC, we are collaborative and team oriented, innovative in our approach, and passionate about our work. We thrive on initiative, creativity and challenges to the status quo. Our employees are valued and empowered. We are proud of our achievements and consider excellence and continuous journey...not a destination end point. If you've got the right stuff and a passion for your work, com journey with us.

OUR MISSION
The Maryland Workers' Compensation Commission seeks to secure the equitable and timely administration of the provisions of the Maryland Workers' Compensation law on behalf of its customer, the injured workers, and their employers, by providing an efficient forum for the resolution of individual claims.

OUR VISION
The Workers' Compensation Commission envisions a state wherein injured workers and employers are empowered to create an equitable partnership to facilitate prompt and fair resolution of workers' compensation matters.

ABOUT US
Together we profoundly touch the lives of so many people and have enormous responsibility to the community by fulfilling our mission of securing equitable and timely administration of the law. The Commission continues to provide services to our constituent partners at a level rarely met throughout the United States. The professionalism, work ethic, and technological acumen manifest in our operations allows us to smoothly and effectively manage the challenges which invariably arise. Every division within the agency plays a vital role in keeping us in the forefront nationally.

GRADE

13

LOCATION OF POSITION

10 East Baltimore St., Baltimore, MD 21202

Main Purpose of Job

The main purpose of this position is to oversee the review, investigation, and processing of workers’ compensation claims involving potentially uninsured employers. Serving as a subject matter expert within the Claims Division, the role ensures that claims are accurately evaluated for Uninsured Employers Fund (UEF) eligibility and handled in compliance with applicable laws and regulations in accordance with COMAR 14.09.05. By conducting detailed coverage research and collaborating with internal divisions, this position supports the agency’s mission to protect injured workers and uphold employer compliance, particularly in response to increased expanded Employer Compliance initiatives.

POSITION DUTIES

UEF Claim Determination & Investigation 
  • Independently review and analyze claims to determine eligibility for designation under the Uninsured Employers Fund (UEF). 
  • Conduct detailed investigations into employer insurance coverage status at the time of injury. 
  • Compile and document findings and communicate determinations to the Insurance Compliance Division as well as other constituents. 
  • Serve as the primary point of review for claims coded or flagged as potential UEF cases. 
  • Independent judgment and analysis in applying and interpreting complex administrative plans or policies. 
  • Confers with other administrative officials, program heads, staff specialists or others in order to exchange information pertaining to UEF claims or interpret policies or offer recommendations.

Claims Processing & Case Management 
  • Manage Workers’ Compensation UEF claims from initial intake through final resolution.
  •  Review, analyze, and process claims documentation for completeness, accuracy, and compliance. 
  •  Ensure UEF claims contain the required claimant’s questionnaire in accordance with COMAR 14.09.02. 
  • Ensure timely and equitable routing of documents and actions through the CompHub system. 

Regulatory Compliance
  •  Apply working knowledge of COMAR14.09.05.01 regulations and Workers’ Compensation statutes to claims handling activities.
  •  Ensure all actions and decisions adhere to legal and procedural requirements. 
  • Identify and escalate compliance issues as appropriate to the Insurance Compliance Division, NCCI, UEF, and/or Director of Claims
  • Monitor claims where attorneys for employer/insurers have not entered their appearance in a claim in accordance with COMAR 14.09.02.08.
  • Receives and codes workers' compensation claims and related case documents;
  • Reviews claims for completeness, accuracy and compliance with agency regulations and procedures;
  • Independently monitor and process workers’ compensation claims from inception through resolution.
  • Review claims to ensure compliance with COMAR 14.09.02.08 regarding attorney entries of appearance for employers and insurers
  • Contact insurers, employers, and legal representatives concerning missing or incomplete attorney appearances.
  • Provide technical guidance and expertise related to workers’ compensation claim procedures and regulatory compliance requirements. 
  • Initiate corrective actions for non-compliance, including preparation and issuance of warning letters.
  • Maintain accurate claim records, correspondence, and documentation within applicable systems.
  • Coordinate with internal staff and external stakeholders to support timely claim administration and compliance enforcement.
  • Determines whether claims may be compensated or deferred for a hearing or held pending the receipt of additional information;
  • Contacts claimants, employers, insurers, attorneys and other members of the compensation community to obtain and clarify pertinent information;
  • Rescinds orders, withdraws claims and amends awards as appropriate;
  • Explains workers' compensation laws and procedures to claimants, employers, insurers, members of the legal and medical professions, and other interested parties;
Other Duties as assigned

MINIMUM QUALIFICATIONS

Education:   Graduation from an accredited high school or possession of a high school equivalency certificate.

Experience: One year of administrative staff or professional work.

Notes:

1. Candidates may substitute 30 college credit hours from an accredited college or university for the required experience.

2. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer involving staff work that included regular use of independent judgment and analysis in applying and interpreting complex administrative plans, policies, rules or regulations or analysis of operational programs or procedures with recommendations for improvement on a year-for-year basis for the required experience.

DESIRED OR PREFERRED QUALIFICATIONS

Three (3) or more years of experience investigating and adjudicating workers' compensation claims, including determining compensability, gathering, and evaluating evidence, and documenting claim findings.

 

Working knowledge of Maryland workers' compensation laws, regulations, and procedures, including familiarity with COMAR 14.09.05.01 and related provisions governing uninsured employers. 

 

Demonstrated ability to exercise independent judgment in interpreting and applying complex statutes, regulations, administrative plans, policies, and procedures.

 

Strong analytical and investigative skills, with the ability to evaluate conflicting information, identify relevant facts, and make well-supported recommendations or determinations.

LIMITATIONS ON SELECTION

This recruitment is limited to current Maryland Workers' Compensation Commission employees.

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator’s license valid in the State of Maryland.

SELECTION PROCESS

Please make sure that you provide sufficient information on your application to show that you meet the qualifications for this recruitment. All information concerning your qualifications must be submitted by the closing date. We will not consider information submitted after this date. Successful candidates will be ranked as Best Qualified, Better Qualified, or Qualified and placed on the eligible (employment) list for at least one year.

BENEFITS

FURTHER INSTRUCTIONS

If you are unable to apply online, or encounter difficulty attaching required or optional documentation, you may submit via mail or deliver in person. Please be sure to include your name, identification number (Easy ID#) and job announcement number (26-002711-0029) on any documentation to ensure timely processing. Submission of a resume is strongly encouraged.

PLEASE DO NOT FAX OR EMAIL UNSOLICITED DOCUMENTATION 

 Completed applications, required documentation, and any required addendums may be mailed to: 
Workers' Compensation Commission
Attn: Personnel Division 
10 E. Baltimore Street, 7th Floor 
Baltimore, MD 21202

 The MD State Application Form can be found online. 

 For more information, please email wccpers@wcc.state.md.us. TTY Users: call via Maryland Relay Workers' Compensation Commission is an equal opportunity employer. It is the policy of WCC that all persons have equal opportunity and access to employment opportunities, services, and facilities without regard to race, religion, color, sex, age, national origin or ancestry, marital status, parental status, sexual orientation, disability or veteran status



Click on a link below to apply for this position:

Fill out the Supplemental Questionnaire and Application NOW using the Internet. Apply Online
View and print the Supplemental Questionnaire. This recruitment requires completion of a supplemental questionnaire. You may view and print the supplemental questionnaire here.
Apply via Paper Application. You may also download and complete the Paper Application here.

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