COMPENSATION CLAIMS ANALYST

Compensation Claims Analyst

State of Rhode Island

$56,123.00 - $63,695.00 Annually

Cranston, RI

Council 94 (2-36)

Department of Labor and Training

Injured Workers Services

Monday - Friday 8 : 30am - 4 : 00pm

Standard 35.0 Hours

Council 94 Local 2869 (27)

Class Definition

General Statement of Duties : To be responsible for examining personal injury reports and claims, as well as settlement agreements relative to personal injuries arising out of and in the course of employment, for the purpose of determining compliance with the provisions of the Workers' Compensation Act; to be responsible for reviewing and verifying workers' compensation computer data reports and to compile statistical data, survey information and reports on various other claim matters for utilization by the Department; and to conduct training classes for adjusters, examiners, and self-insured in Workers' Compensation procedures as per law and department rules and regulations; and to do related work as required. Supervision Received : Works under the general supervision of a superior with latitude in the exercise of initiative and independent judgement; work must be in compliance with departmental policies, rules, regulations, and provisions of the Act. Supervision Exercised : Reviews for accuracy and compliance, both in process and upon completion the work of a professional, licensed staff of insurance claims examiners and adjusters in private industry engaged in processing claims for compliance's with the Act.

Illustrative Examples of Work Performed

To be responsible for examining personal injury reports, claims as well as settlement agreements relative to personal injuries arising out of and in the course of employment, for the purpose of determining compliance with the provisions of the Workers' Compensation Act; and to be responsible for reviewing and verifying workers' compensation computer data and reports and to compile statistical data, survey information and reports on various other claim matters for utilization by the Department, including Cost of Living Adjustments and other changes ongoing in the Act.

To be responsible for verifying and / or determining the payments of benefits, compensation, and other related services rendered to the injured claimant.

To have the ability to understand and retain present and past laws regulating workers' compensation, and to keep abreast of rulings which impact the current statute.

To provide technical advice and assistance to all parties involving their rights and obligations under the Workers' Compensation Act.

To provide both routine and technical information to the general public and professional community regarding their rights and responsibilities.

To conduct both informal and formal training seminars, in the office, on the telephone, and outside the office, instructing persons as to the proper procedures in completing forms, the report form filing process, changes in the law, and other related information.

To understand and record the paperwork initiated by the Workers' Compensation Court.

To be responsible for the establishment and maintenance of an effective record-keeping system for assigned claimants and their compensation payments.

To operate data entry equipment, as required.

To do related work as required.

Required Qualifications for Appointment

Knowledges, Skills and Capacities : A thorough knowledge of the provisions of the Workers' Compensation Act, and the ability to apply such knowledge in the examination of, or the preparation and processing of, workers' compensation injury reports and claims, as well as settlement agreements relative to injuries arising out of, or in the course of employment; a working knowledge of medical terminology as it related to injuries, occupational diseases and disabilities; the ability to compile, interpret and disseminate data, and to make sound decisions in applying the provisions of the Act; a working knowledge of data processing methods and techniques utilized in the processing of workers' compensation claims; the ability to communicate with all involved parties including injured workers, employers, insurance carriers, lawyers and other interested parties; and related capacities and abilities.

Education and Experience :

Education : Such as may have been gained through : graduation from a senior high school, supplemented by at least one year of higher education which included courses such as oral communication, accounting, and medical terminology; and Experience : Such as may have been gained through : employment in a position involving the collection, analysis and evaluation of data relevant to the processing of workers' compensation benefits, insurance claims, or other similar areas of claim activity. Or, any combination of education and experience that shall be substantially equivalent to the above education and experience.