Claims Advisor

Claims Advisor Job

ID220885

Location Shawnee County Full/Part TimeFull-Time AgencyDepartment of Administration Job Posting Important Recruitment Information for this vacancy:

Job Posting Closes:

May 20th, 2026 Department of Administration, State Self Insurance Fund https://ssif.healthbenefitsprogram.ks.gov/ Verification of identity and employment eligibility to work in the United States is required by federal law. For a list of acceptable documents that establish these criteria, please refer to the federal Form I-9. While the Department of Administration (D of A) welcomes all candidates legally eligible to work in the United States, D of A does not provide sponsorships for this position.

E-Verify:

Kansas Department of Administration (D of A) participates in E-Verify and will provide the federal government with your I-9 information to confirm that you are authorized to work in the U.S. For additional information regarding E-Verify, please click here. For additional information regarding Immigrant and Employee Rights (IER) please click here. About the

Position:

Who can apply: Anyone

Classified/Unclassified Service:

Unclassified

Full/Part-time:

Full-Time

Regular/Temporary:

Regular

FLSA Status:

Non-Exempt

Work Schedule:

Monday-Friday 8:00 am to 5:00 pm Eligible to

Receive Benefits:

Yes

Veterans' Preference Eligible:

Yes

Compensation:

Salary Range:

$19.46 - $20.96/hr

Note:

Salary can vary depending upon education, experience, or qualifications.

Employment Benefits:

First day of employment coverage under the State Employee Health Plan (SEHP) for medical and prescription drug coverage and dental plan. Additional voluntary options including vision, hospital indemnity, accident and critical illness insurance plans and flexible spending accounts. SEHP members and their covered family members have access to the HealthQuest Health Center at 9th and Kansas Avenue in Topeka for in-person and virtual health care services. Sick & Vacation leave Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave Paid State Holidays (designated by the Governor annually) Employee discounts with the STAR Program Retirement and deferred compensation programs Visit the Employee Benefits page for more information

Position Summary:

Adjudicates claims and coordinates benefits under the Workers Compensation Act, rules and regulations, office policy and prior case law. Acknowledge and respond promptly by phone and/or in writing to inquiries from injured workers, physicians, agencies, and others. Notify injured worker and agency in writing when the claim is determined not to be compensable. Consult and educate injured workers regarding their rights and benefits, provide them with helpful information to access and receive benefits. Obtain and review supporting medical records to determine whether medical bills are reasonable and necessary before approving payment. Verify claimant reimbursement for mileage, per diem and out-of-pocket expenses. P{repare and

Maintain Claims:

Update claims management system with appropriate information necessary to track claims. Maintain all required active electronic files, utilizing ImageNow and SIMS. Match, review, and act on all documents related to claims that are scanned to the adjuster specific queue. Review claim files frequently in order to take appropriate action to assure injured workers are receiving appropriate medical care. Periodically review case load for claims that can be closed. Attend staff team meetings or in-service medical care provider training to keep abreast of injured workers' medical progress and medical treatment options.

Investigate Workers Compensation Claims:

Receive electronic reports of "Medical Only" cases; plan and conduct telephone interviews with claimants, supervisors, witnesses and others relative to the accident (who, what, when, where, who witnessed, primary cause). Write clear and concise summary of the investigation, findings of fact and conclusions of compensability. Collect personal records and division records (when appropriate), medical records and all other documentation as necessary to determine compensability. When necessary, report claims of fraud and/or abuse to an assistant attorney general for possible prosecution of claimants, attorneys, doctors, and others. Determine if there is cause to review evidence to ensure recovery expenditures from negligent third parties, product liability. May compute settlement on "Medical Only" case for supervisor approval. Coordinate Return to

Work:

Collaborate with injured workers, medical providers, Department of Administration, agency personnel and attorneys to maximize early Return to Work. Stimulate return to work discussion when injured workers have not been return to duty. Coordinate job site evaluations or rehabilitation evaluations as necessary. Advise injured workers that other benefits such as vacation leave, sick leave and Family and Medical Leave Act may apply. Inform agency personnel office of injured workers' status for the purpose of coordinating FMLA or other benefits for injured employees. Perform other duties as assigned.

Minimum Qualifications:

One year of experience interacting with clients, customers, or the public in a social service, customer service, or problem resolution setting. Education may be substituted for experience as determined relevant by the agency. Valid driver's license.

Post Offer Requirement:

Kansas Tax Clearance Certificate:

A valid Kansas Tax Clearance Certificate is a condition of employment for all employees of the State of Kansas. Applicants (including non-residents) who receive a formal job offer for a State job, are required to obtain a valid Tax Clearance within ten (10) days of the job offer. A Tax Clearance can be obtained through the Kansas Department of Revenue who reviews individual accounts for compliance with Kansas Tax Law. If you have a missing tax return(s) or you owe taxes to the State of Kansas, please know that the Kansas Department of Revenue will work with you. The Kansas Department of Revenue can set you up on a payment plan to receive a Tax Clearance so you can get a job working for the State of Kansas. The Kansas Department of Revenue can be contacted at 785-296-3199. Kansas Department of Revenue - Tax Clearance Frequently Asked Questions Recruiter Contact Information

Name:

Brianna Brandt Email:

Brianna.brandt@ks.gov