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SO
State of Ohio - Workers' Compensation
Cincinnati - Workers Compensation Claims Assistant (PN: 20068812 & 20069620)
Career Insights for Claims Examiner (General)
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Scorecard
Based on Ohio data
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What they do
A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.
$77,591 / year median in Ohio
+8% projected growth
Job Description
What our Employees Have to
Say:
BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include: BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work. I have worked at several state agencies and BWC is the best place to work. Best place to work in the state and with a sense of family and support. I love the work culture, helpfulness, and acceptance I've been embraced with at BWC. I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC. If you are interested in helping BWC grow, please BWC's core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC's seven offices across the state. BWC offers flex-time work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.What You'll Be Doing:
Adjudicating system to monitor claims work list & manage caseload of Percentage of Permanent Partial applications Determine if waiting period has lapsed from date of injury in Medical Only claim or date of last compensation in lost time claims ProcessesC92/C92A
applications (e.g. mails applications received to employers &/or reps, reviews applications & Workers' Compensation Claims Management System (Claims Management System) to ensure timely filing Requests medical documentation & wage information from (e.g. MCOs, SI Employers, IWs, Employers) as appropriate Generates Tentative Orders on Claims Management System for all state fund and SI claims by entering required data into computer form (e.g. percentage of permanent partial, additional conditions) Why Work for the State of Ohio At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees•. For a list of all the State of Ohio Benefits, visit our Total Rewards website!Our benefits package includes:
Medical Coverage Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period Paid time off, including vacation, personal, sick leave and 11 paid holidays per year Childbirth, Adoption, and Foster Care leave Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more) Public Retirement Systems (such as OPERS, STRS, SERS, and HPRS) & Optional Deferred Compensation (Ohio Deferred Compensation) Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.Qualifications To Qualify, You Must Clearly Demonstrate:
2 courses or 6 months experience in English composition or grammar AND 2 courses or 6 months experience in accounting, bookkeeping or general math AND 2 courses or 6 months experience in communication or public speaking or 6 months experience in a position involving receiving & responding to public inquiries or complaints or involving contact with injured workers, employers, legislators, providers or their representatives & public AND successful completion of one typing course or demonstrate ability to type 35 words per minute. Or equivalent of Minimum Class Qualifications For Employment noted above.Note:
Classification may require use of proficiency demonstration to determine minimum class qualifications for employment.Job Skills:
Claims Examination Major Worker Characteristics:
Knowledge of:
BWC & IC
policies & standard operating procedures- ; ORC rules & regulations
- ; applicable state & federal regulations governing documents processed, reviewed &/or prepared
- ; public relations; BWC claims documents & forms
- ; SI
- ; IC
- ; CCT
- ; BWC claims-related terminology
Skill in:
operation of PC to efficiently log & enter data; claims adjudicating systems; use of general office equipment (e.g. telephone, copier/fax machine).Ability to:
solve practical, everyday problems, gather, collage & classify information about practical, everyday problems, gather, collate & classify information about data people or things; handle routine inquiries from & contacts with injured workers, employers, legislators. (- ) developed after employment.
- Position requires travel; therefore, persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.