NYC Jobs
ASSISTANT SUPERVISOR- BENEFITS EXAMINER LEVEL 2
NYC Jobs, Brooklyn, New York, United States, 11210
Job Title
This position is for Law Department employees only. You must be permanent in the title or currently serving provisionally in the title and have taken the most recent Workers' Compensation Benefits Examiner exam number 5141. Under direct supervision, the role receives and processes incoming workers' compensation claims. The tasks include reviewing accident reports and other documents related to incoming claims to determine workers' compensation coverage. The duties also involve setting up computer files, entering information into the computer, and updating computer records. Additionally, the role contacts City agency staff to make inquiries regarding claims, returns incomplete claims to the appropriate party for additional information, and gathers information from case files or computer records to prepare written material and forms for distribution. The position responds to telephone inquiries from claimants and their attorneys and physicians, schedules independent medical examinations to determine entitlement to workers' compensation benefits, makes inquiries about medical background of claimants, and reviews pending cases for possible third party coverage. The role prepares recommendations for compensation, processes payment for medical treatment, computes benefit payments accruing to prospective recipients, their beneficiaries, or medical providers, and benefits and payment calculations involving workers' compensation awards and medical bills. The position investigates difficult cases and claimant's alleged accident(s) and disability(ies) by contacting witnesses, city agencies, physicians, and other pertinent parties. Reviews cases upon return from hearings to make payments or corrections of any awards and fees or decisions from the State Workers' Compensation Board, to authorize the Comptroller to issue payments, to determine the need for scheduling independent medical examinations, witness and doctor's testimony; to request that appropriate parties conduct investigations/surveillance, as required; to authorize treatments; and to follow up on directives issued by legal and management staff. Examines and processes claims and bills submitted by medical practitioners and hospitals for payment or objection, authorizes the Comptroller to issue payment of proper fee based upon the New York State Workers' Compensation Board medical bill fee schedule, reviews medical reports submitted by claimants, doctors, and City doctors to determine continuing eligibility for benefits, reviews cases and determines the need for and type of medical consultation appropriate to the circumstances of the cases, reviews claims for processing voluntary awards of workers' compensation benefits, trains less experienced Workers' Compensation Benefits Examiner, identifies medical information needed to reach a conclusion regarding the current and past disability, and the relationship between such disability and the alleged injury, and seeks to recover overpayments made to workers' compensation claimants and medical providers through error or fraud. May supervise and evaluate assigned staff members. In the temporary absence of supervisor, may assume the duties of that position. New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview. Minimum Qualifications: 1. An associate degree or completion of 60 semester credits from an accredited college or university, including or supplemented by 6 semester credits in mathematics, statistics, accounting, and/or actuarial science; or 2. A four-year high school diploma or its educational equivalent and one year of satisfactory full-time experience implementing the provisions of a workers' compensation or retirement or medical benefits plan, involving the use of mathematical, statistical, actuarial, or accounting computations; or 3. A combination of education and/or experience equivalent to "1" or "2" above. Satisfactory completion of 30 semester credits from an accredited college, including 3 semester credits in mathematics, statistics, accounting and/or actuarial science may be substituted for 6 months of the full-time experience as described in "2" above. However, all candidates must possess at least a four-year high school diploma or its educational equivalent. Special Note: A. Upon completion of one year of satisfactory continuous service in Assignment Level Ia, employees shall be assigned to Assignment Level Ib. B. To be eligible for placement in Assignment Level Ib or II, individuals must have, in addition to meeting the minimum requirements, either: 1. One additional year of satisfactory full-time experience implementing the provisions of a workers' compensation or retirement or medical benefits plan involving the use of mathematical, statistical, actuarial, or accounting computations; or 2. A baccalaureate degree from an accredited college including or supplemented by 6 semester credits in mathematics, statistics, accounting and/or actuarial science. Special Note: C. To be eligible for placement in Assignment Level III, individuals must have, in addition to meeting the minimum requirements, either: 1. Two additional years of full-time experience as described in "Note B. 1" above; or 2. A baccalaureate degree from an accredited college including or supplemented by 6 semester credits in mathematics, statistics, accounting and/or actuarial science and one additional year of satisfactory full-time experience as described in "Note B. 1" above. This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program. As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education's website at . New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview. The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.
This position is for Law Department employees only. You must be permanent in the title or currently serving provisionally in the title and have taken the most recent Workers' Compensation Benefits Examiner exam number 5141. Under direct supervision, the role receives and processes incoming workers' compensation claims. The tasks include reviewing accident reports and other documents related to incoming claims to determine workers' compensation coverage. The duties also involve setting up computer files, entering information into the computer, and updating computer records. Additionally, the role contacts City agency staff to make inquiries regarding claims, returns incomplete claims to the appropriate party for additional information, and gathers information from case files or computer records to prepare written material and forms for distribution. The position responds to telephone inquiries from claimants and their attorneys and physicians, schedules independent medical examinations to determine entitlement to workers' compensation benefits, makes inquiries about medical background of claimants, and reviews pending cases for possible third party coverage. The role prepares recommendations for compensation, processes payment for medical treatment, computes benefit payments accruing to prospective recipients, their beneficiaries, or medical providers, and benefits and payment calculations involving workers' compensation awards and medical bills. The position investigates difficult cases and claimant's alleged accident(s) and disability(ies) by contacting witnesses, city agencies, physicians, and other pertinent parties. Reviews cases upon return from hearings to make payments or corrections of any awards and fees or decisions from the State Workers' Compensation Board, to authorize the Comptroller to issue payments, to determine the need for scheduling independent medical examinations, witness and doctor's testimony; to request that appropriate parties conduct investigations/surveillance, as required; to authorize treatments; and to follow up on directives issued by legal and management staff. Examines and processes claims and bills submitted by medical practitioners and hospitals for payment or objection, authorizes the Comptroller to issue payment of proper fee based upon the New York State Workers' Compensation Board medical bill fee schedule, reviews medical reports submitted by claimants, doctors, and City doctors to determine continuing eligibility for benefits, reviews cases and determines the need for and type of medical consultation appropriate to the circumstances of the cases, reviews claims for processing voluntary awards of workers' compensation benefits, trains less experienced Workers' Compensation Benefits Examiner, identifies medical information needed to reach a conclusion regarding the current and past disability, and the relationship between such disability and the alleged injury, and seeks to recover overpayments made to workers' compensation claimants and medical providers through error or fraud. May supervise and evaluate assigned staff members. In the temporary absence of supervisor, may assume the duties of that position. New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview. Minimum Qualifications: 1. An associate degree or completion of 60 semester credits from an accredited college or university, including or supplemented by 6 semester credits in mathematics, statistics, accounting, and/or actuarial science; or 2. A four-year high school diploma or its educational equivalent and one year of satisfactory full-time experience implementing the provisions of a workers' compensation or retirement or medical benefits plan, involving the use of mathematical, statistical, actuarial, or accounting computations; or 3. A combination of education and/or experience equivalent to "1" or "2" above. Satisfactory completion of 30 semester credits from an accredited college, including 3 semester credits in mathematics, statistics, accounting and/or actuarial science may be substituted for 6 months of the full-time experience as described in "2" above. However, all candidates must possess at least a four-year high school diploma or its educational equivalent. Special Note: A. Upon completion of one year of satisfactory continuous service in Assignment Level Ia, employees shall be assigned to Assignment Level Ib. B. To be eligible for placement in Assignment Level Ib or II, individuals must have, in addition to meeting the minimum requirements, either: 1. One additional year of satisfactory full-time experience implementing the provisions of a workers' compensation or retirement or medical benefits plan involving the use of mathematical, statistical, actuarial, or accounting computations; or 2. A baccalaureate degree from an accredited college including or supplemented by 6 semester credits in mathematics, statistics, accounting and/or actuarial science. Special Note: C. To be eligible for placement in Assignment Level III, individuals must have, in addition to meeting the minimum requirements, either: 1. Two additional years of full-time experience as described in "Note B. 1" above; or 2. A baccalaureate degree from an accredited college including or supplemented by 6 semester credits in mathematics, statistics, accounting and/or actuarial science and one additional year of satisfactory full-time experience as described in "Note B. 1" above. This position is also open to qualified persons with a disability who are eligible for the 55-a Program. Please indicate at the top of your resume and cover letter that you would like to be considered for the position through the 55-a Program. As a prospective employee of the City of New York, you may be eligible for federal loan forgiveness programs and state repayment assistance programs. For more information, please visit the U.S. Department of Education's website at . New York City residency is generally required within 90 days of appointment. However, City Employees in certain titles who have worked for the City for 2 continuous years may also be eligible to reside in Nassau, Suffolk, Putnam, Westchester, Rockland, or Orange County. To determine if the residency requirement applies to you, please discuss with the agency representative at the time of interview. The City of New York is an inclusive equal opportunity employer committed to recruiting and retaining a diverse workforce and providing a work environment that is free from discrimination and harassment based upon any legally protected status or protected characteristic, including but not limited to an individual's sex, race, color, ethnicity, national origin, age, religion, disability, sexual orientation, veteran status, gender identity, or pregnancy.