CLAIMS CLERK

The State of New Hampshire, Labor Department, Workers Compensation Division has a full-time vacancy for a Claims Clerk.

Summary:

Performs technical and clerical tasks in support of the Workers’ Compensation Division. Reviews and processes workers' compensation claims and provides information and resources to the public, employers, and insurance companies regarding the provisions of the law and administrative rules. Compiles statistical information and prepares reports using word processing and computer equipment. Responsible for partial supervision of other claims staff.

YOUR EXPERIENCE COUNTS: Each additional year of approved formal education may be substituted for one year of required work experience and/or each additional year of approved work experience may be substituted for one year of required formal education.

MINIMUM QUALIFICATIONS:

Education/Experience: Equivalent combination of 2 years of education and experience after completion of high school. Education and experience must be in the fields of clerical or claims or related field.

License/Certification: None

Other Requirements: None

Trainee Option: Not applicable

PREFERRED QUALIFICATIONS:

Knowledge of modern office practices and procedures. Knowledge of principles of office management. Knowledge of claims and hearings procedures. Ability to keep complex records and to prepare periodic reports from such records. Ability to gather, assemble, correlate and analyze facts and identify existing or potential problems. Ability to establish and maintain good working relationships with other employees and the general public. Must be willing to maintain appearance appropriate to assigned duties and responsibilities as determined by the agency appointing authority.

AFTER-HIRE REQUIREMENTS: None

CAREER ADVANCEMENT OPPORTUNITIES:

In-Band Advancement Available: Yes No

Broad Group Level Advancement Available: Yes No

DISCLAIMERS:

The supplemental job description lists the essential functions of the position and is not intended to include every job duty and responsibility specific to the position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that job title.

The work of an employee in trainee status in this position shall be overseen by a fully qualified individual. An employee in trainee status shall meet the minimum qualifications within the period of time specified on the SJD, not to exceed one year of being hired into this position.

Responsibilities:

Responsible for reviewing Memo's of Denial and Payment, identifying unacceptable denials or inaccurate compensation rates; corrects compensation amounts if required, and provides follow-up and notification to carriers as necessary.

Assists in the review and calculation of cost-of-living adjustments to determine changes in eligibility amounts.

Investigates complex problem claims, advising parties as to respective rights and responsibilities and eliciting compliance of individuals involved. Communicates with employers, employees, and insurance companies to arrive at resolutions; consults with superior as needed.

Corresponds with a variety of individuals regarding rights and obligations, explaining the provisions of the law and departmental policies and procedures.

Assists claimants, employers, insurers, attorneys, and health care providers in workers' compensation related matters to ensure that filing procedures and claims processes are understood.

Investigates inquiries by the public regarding the proper handling of workers’ compensation claims including, completion of appropriate forms, submission of medical records, and coordination with insurance carriers.

Interviews and records information from complaints through phone calls, correspondence or in-person

Monitors the performance of insurance carriers in complying with department hearing decisions, recommending the issuance of civil penalties for failure to comply.

Maintains a computer tracking system to follow up with claimants who are having difficulty with their employers in the filing of their workers’ compensation claim.

Provides information to other state and federal agencies for verification of benefits.

For further information please contact Pat Goulet, Supervisor at patricia.a.goulet@dol.nh.gov or 603-271-3328.

*TOTAL COMPENSATION INFORMATION

The State of NH total compensation package features an outstanding set of employee benefits, including:

HMO or POS Medical and Prescription Drug Benefits:

The actual value of State-paid health benefits and the amount of employee health benefit contributions may vary depending on the type of plan selected and the bargaining unit with which a position is associated.

See this link for details on State-paid health benefits:

https://www.das.nh.gov/hr/benefits.aspx

Value of State's share of Employee's Retirement: 12.87% of pay

Other Benefits:

• Dental Plan at minimal cost for employees and their families ($500-$1800 value)

• Flexible Spending healthcare and childcare reimbursement accounts

• State defined benefit retirement plan and Deferred Compensation 457(b) plan

• Work/life balance flexible schedules, paid holidays and generous leave plan

• $50,000 state-paid life insurance plus additional low-cost group life insurance

• Incentive-based Wellness Program (ability to earn up to $500)

Total Compensation Statement Worksheet:

https://www.das.nh.gov/jobsearch/compensation-calculator.aspx

Want the specifics? Explore the Benefits of State Employment on our website:

https://www.das.nh.gov/hr/documents/BenefitBrochure.pdf

https://www.das.nh.gov/hr/index.aspx

EOE

TDD Access: Relay NH 1-800-735-2964