Workers’ Compensation Claims Specialist II
800 W. Washington
Are you ready to work for an exceptional state agency that works to protect the life, health and welfare of the employees in the State of Arizona? Apply with us! The Industrial Commission of Arizona (ICA) is committed to the highest standards of compliance, demonstrating leadership in all areas, and teaching and working with employers and employees to make them successful. A thriving workforce in Arizona is what we strive for and work towards each day.
This position is responsible for auditing incoming claims documents for compliance with applicable workers compensation claims management laws, statutes, and case laws. This position will critically analyze submitted forms for compliance and issue appropriate awards when indicated. In addition, this position audits insurance carriers, self-insured employers and third party administrators adjusting workers compensation claims; reviews all notices, attached medical and/or documentation to verify it supports current change of status and/or calculation of wage and awards; issues correct corresponding award, notification, or document; answers incoming phone calls from injured workers, attorneys, interested parties, claim adjusters, medical providers and general public; researches information in Claims database; creates a new claim file for documents received when there is no existing claim file; provides backup assistance to data entry, error resolution, insurance or combine/delete, as needed and participates in Arizona Management System (AMS) and daily Huddle board; attend staff meetings, seminars, conferences, training classes; as indicated.
As a State of Arizona agency, the ICA offers an excellent benefits package, including top-ranked retirement and long-term disability plans, affordable medical, dental, vision, life and short-term disability plans, 10 paid holidays per year, 13 paid vacation days and 12 paid sick days per year, and a deferred compensation plan option.
- Basic knowledge of applicable workers compensation claims management laws, statutes, case laws.
- Basic Medical terminology.
- Microsoft Office Suite; Outlook, Word, Excel.
- Basic English
- Basic Mathematics
- The insurance industry claims adjusting standards and practices.
- Effectively able to communicate verbally and in writing to resolve disputes with interested parties.
- Basic analysis of insurance, medical and legal documents.
- Review and interpret Arizona Workers' Compensation laws, rules, procedures and court decisions
- Strong critical thinking skills
- Time Management
- Initiative and attention to detail
- Strong focus on customer service
- Strong organizational and planning skills
- Responsible for high quality, nearly error-free output
- Basic organizational, analytical, managerial and supervisory skills.
- Basic Business process acumen, management skills including work flows and information management.
- Strong leadership, time management, and organizational skills.
- Interpret medical records to determine physical limitations for injured workers.
- Manage heavy workload with high level of accuracy and production.
- Learn computer systems and applications.
- Work well within a diverse and inclusive office environment.
- Timely process documents within established productivity standard and prioritizes work within established time frames.
- Manage time effectively and meet deadlines.
- Adapt to changing circumstances.
- Demonstrate initiative and attention to detail.
- Exercise discretion and judgment.
- Works well under pressure.
- Ability to perform job responsibilities incorporating lean management and principles of the Arizona Management System.
- Effectively train internal and external customers in small and large group settings.