Insurance Fund, State
Albany, NY
The duties that the incumbent of the vacancy will be expected to perform. Duties Description Under the general supervision of a Claims Services Representative 2 responsibilities include, but are not limited to: • Oversee all aspects of workers compensation claims processing from inception to closing• Initially determine the compensability of claims and file appropriate documentation with the Workers Compensation Board (WCB) • Calculate and adjust reserves consistent with case analysis over the anticipated life of the claim • Recommend cases for appeal to WCB• Negotiate and/or make recommendations regarding lump sum settlements • Issue payments and request for reimbursement where claims for supplemental benefits are involved • Review awards to ensure the correct recipient and rate of compensation• Schedule or waive medical examinations as necessary • Analyze medical bills to determine causality, levels of treatment, necessity for treatment, appropriateness of fees and procedure...

