State Workers' Insurance Fund Claims Representative

The Position

Do you enjoy investigative work and have a keen eye for detail? If so, consider joining the State Workers' Insurance Fund (SWIF) as a Claims Representative. This position gives you the opportunity to investigate, process, and manage reported work-related claims for employees of policy holders covered by the State Workers' Insurance Fund for the purpose of determining compensability. Advance your professional career with this exciting opportunity.

Description Of Work

As a Claims Representative, you will monitor and control all aspects of the claim from beginning to its conclusion. Work involves completing an investigation for reported incidents / claims and processing acceptance or denial within the time frame as prescribed by law. This position reviews and makes determinations relating to applicability of pre-existing conditions and impact on claims and handles all aspects of minor disability / lost time claims with anticipated lost time of less than eight weeks. You will have the opportunity to make determinations to identify potential fraud; documenting and reporting all suspected fraud to the SWIF fraud investigator and supervisor. Effective communication will be key as you will have the opportunity to contact appropriate parties related to the reported claim including claimants, employers, doctors, hospitals, and witnesses to determine eligibility for workers' compensation benefits. If you are detail oriented with excellent customer service skills, we want you on our team!

Interested in learning more? Additional details regarding this position can be found in the position description.

Work Schedule and Additional Information :

• Full-time employment
• Work hours are 8 : 00 AM to 4 : 00 PM, Monday - Friday, with 30-minute lunch.
• Telework : You may have the opportunity to work from home (telework) part-time. In order to telework, you must have a securely configured high-speed internet connection and work from an approved location inside Pennsylvania. If you are unable to telework, you will have the option to report to the headquarters office in Pittsburgh. The ability to telework is subject to change at any time. Additional details may be provided during the interview.
• Salary : In some cases, the starting salary may be non-negotiable.
• You will receive further communication regarding this position via email. Check your email, including spam / junk folders, for these notices.

Required Experience, Training & Eligibility

Qualifications

Minimum Experience and Training Requirements :

Additional Requirements :

How to Apply :

Veterans :

Telecommunications Relay Service (TRS) : 711 (hearing and speech disabilities or other individuals).

If you are contacted for an interview and need accommodations due to a disability, please discuss your request for accommodations with the interviewer in advance of your interview date.

The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply.