HUMAN RESOURCES ASSISTANT - Office of Workers' Compensation

Augusta, Maine, United States Full-time

Application closes: Oct. 18, 2019

Office of Workers’ Compensation

HUMAN RESOURCES ASSISTANT

 

CODE:  0458                       PAY GRADE: 17(X)     SALARY: $16.62 – $22.04/hour

OPEN FOR RECRUITMENT:  October 3, 2019

CLOSES:  October 18, 2019

 

JOB DESCRIPTION

This is paraprofessional support working in receiving, processing, tracking and maintaining records on workers’ compensation claims and cases.  This is done primarily by entering collected data/information into the America Technical Services – Risk Management Information System (ATS RMIS) computer program system.  Responsibilities include ensuring medical and other documentation is complete and accurate and entered in the ATS RMIS program; communicating with physicians, departmental designees, contract vendors, claimants and others; scheduling independent medical examinations; authorizing special medical services; approving payments of certain expenses; and managing medical only claims filed by and/or on behalf of state employees.  Work is performed under limited supervision in support of and as a team member by a Workers’ Compensation Case Manager.

 

TYPICAL DUTIES

 

  • Makes eligibility decisions and manages Medical Only claim files, and assists designees in the filing of proper and timely paperwork in order to ensure accurate and timely authorization and payment of bills.
  • Reviews bills; authorizes payments; enters bill information into ATS system in order to pay the bills.
  • Reviews medical documentation received; enter summary of information into ATS system in order to maintain an electronic record of the claim.
  • Examines and verifies workers’ compensation claims, reports and benefit eligibility requirements in order to ensure accuracy and completeness of materials and make benefit eligibility recommendations.
  • Receives and examines medical and claims documentation, including diagnosis and treatment in order to determine consistency with claimed injuries, and process claims for payment or controverting.
  • Conducts research utilizing various computer data bases, manuals and case files in order to respond to questions, resolve problems, make decisions or provide needed information.
  • Compiles and assembles case records, reports, and other necessary documentation in order to assist in the preparation of legal cases and/or mediation.
  • Explains provisions of applicable laws, rules, regulations, and policies to employees, designees, nurse case managers and others in order to encourage proper benefit utilization.
  • Reviews medical reports received for possible issues; discusses with the case manager and takes action required in order to prevent/resolve problems.
  • Receives payments and returned checks; researches reason for payment or return; corrects errors in the ATS system and/or prepares deposit in order to ensure accurate payment of bills and receipt of funds.

 

REQUIREMENTS

Education, training, and/or experience which provides a basic knowledge and understanding of human resource functions.  Preference will be given to those applicants with experience in worker’s compensation administration.

BENEFITS

The value of State’s share of Employee’s Retirement:  19.27% of salary for confidential positions.  The value of State-paid Dental Insurance:  $14.31 biweekly.  The value* of State-paid Health Insurance:

 

  • Level 1:  100% State Contribution (employee pays nothing):  $461.75 biweekly
  • Level 2:    95% State Contribution (employee pays 5%):  $438.66 biweekly
  • Level 3:    90% State Contribution (employee pays 10%):  $415.58 biweekly
  • Level 4:      85% State Contribution (employee pays 15%):  $392.49 biweekly

 

*The level of the actual value of state paid Health Insurance will be based on the employee’s wage rate and status with regard to the health credit premium program.

 

FOR MORE INFORMATION, CONTACT:

Mindy Hansen

Human Resources Generalist

207-624-7430 (T)

Melinda.Hansen@maine.gov