Duties Description Under the direction of the Senior Workers' Compensation Examiner within the Office of General Counsel’s Adjudication Services Bureau, the Workers' Compensation Examiner duties will include but not limited to:
- Reviews all case activity, and appropriately routing issues disputes, supports the adjudication of claims; ensures compliance with applicable laws, rules, and regulations.
- Reopens inactive or closed claims to resolve new issues, requests meetings or hearings, ensures that a claims case is ready for the judge’s review, and ensures employers and payers are in compliance with the applicable laws, rules, and regulations.
- Reviews claims case file to determine if required forms and documents have been received; requests missing information from appropriate party; may prepare claims file, and if applicable according to specified criteria, prepares administrative decision for judges’ approval or prepares the file for presentation to judge for action.
- Processes judges' decisions and explains decisions to claimants, responds to questions and provides information on appeal procedures to claimants, employers, insurance carriers and attorneys, and reviews requests for appeal or reopening of a closed case to resolve new issues.
- Maintains the calendar and the schedule of the Senior Judge and the judges including hearings, conferences and meetings.
- Receives, reviews, organizes, and processes correspondences, court filings, notices, and other legal documents.
- Prepares, types, proofreads, and distributes memoranda, notices, reports, and correspondences.
- Maintains confidential case files, records, and administrative materials in accordance with Board's procedures and policies.
- Answers telephones and responds to inquiries from attorneys, claimants, carriers, and members of the public.
- Coordinates communication between adjudication, attorneys, and the parties.
- Assists in preparing calendar coverage assignments, PHC charts and any other materials for hearings.
- Inputs, retrieves, and updates information using the CIS and other Board's software applications.
- Schedules appointments and meetings and arranges logistical support as necessary.
- Receives and distributes mail, email communications, and legal documents.
- Review claims case file to determine if required forms and documents have been received; requests missing information from appropriate party; may prepare claims file, and if applicable according to specified criteria, prepares administrative decision for judges’ approval or prepares the file for presentation to judge for action.
- Maintains office supplies and assists in the general organization and operation of the adjudication office.
- Performs any related clerical and administrative duties as assigned by the Senior Judge.
Minimum Qualifications This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).
For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply. At this time, agencies may recruit and hire employees by making permanent non-competitive appointments and the official probationary period will begin.
At a future date (within one year of permanent appointment), it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified.
NON-COMPETITIVE MINIMUM QUALIFICATIONS:
Candidates must have:
Either 1. Three years of full-time experience in a position where your primary responsibilities included extensive in-person or telephone customer service experience with the general public resolving customer's issues and/or problems; explaining programs/services, policies, or procedures; reconciling accounts; or experience examining, investigating, processing, or adjusting insurance claims; or responding to technical questions from policyholders or claimants;
Or 2. An Associate degree may substitute for two years of specialized experience described in #1;
Or 3. A bachelor's degree may substitute for four years of specialized experience described in #1
55 B/C QUALIFICATIONS:
Individuals certified eligible for the 55b/c program under the Governor’s Program to Hire Persons/Veterans with Disabilities pursuant to Section 55b/c of the Civil Service Law will also be considered. To be considered, you must meet the minimum qualifications and provide a copy of your letter of eligibility with your response.
COMPETITIVE MINIMUM QUALIFICATIONS:
CIVIL SERVICE LIST APPOINTMENT:
Candidates must be reachable on the appropriate Civil Service eligible list.
TRANSFER QUALIFICATIONS:
Candidates must have one year permanent or 55 b/c service in a title designated as appropriate for transfer in accordance with 70.1 of the Civil Service Law.
Additional Comments Please Note: This position requires both in-office and remote work. A hybrid telecommuting schedule can be discussed with the hiring manager during the interview.
We offer a work-life balance and a generous benefits package, including:
Holiday & Paid Time Off
- Thirteen (13) paid holidays annually.
- Thirteen (13) days of paid vacation leave in year one, increasing to 20+ days with additional years of service.
- Five (5) days of paid personal leave annually.
- Thirteen (13) days of paid sick leave annually for PEF/CSEA and eight (8) days paid sick leave annually for M/C.
- Annual professional leave and educational leave opportunities for eligible staff.
Health Care Benefits
- Eligible employees and dependents can choose from a variety of affordable and generous health insurance programs.
- Family dental and vision benefits at no additional cost.
Additional Benefits
- Public Service Loan Forgiveness (PSLF).
- Enrollment in the New York State pension system which has earned the distinction of being one of the best-managed and best-funded plans in the nation OR Optional Retirement Defined Contribution Plan with 8% salary match (eligibility requirements apply).
- NYS Deferred Compensation and an exclusive 403(b) Optional Retirement Savings Plan.
- Paid Parental Leave for all employees and Paid Family Leave (M/C Only).
- Eligibility for various life insurance options.
- Access to NY 529 and NY ABLE College Savings Program
- Flexible Spending Program, which allows employees to set aside pre-tax payroll deductions for eligible health care and dependent care expenses.
For new State employees appointed to graded positions, the annual salary is the hiring rate (beginning of the Salary Range) of the position. Promotion salaries are calculated by the NYS Office of the State Comptroller in accordance with NYS Civil Service Law, OSC Payroll rules and regulations and negotiated union contracts.
The Workers’ Compensation Board (Board) is an equal opportunity employer. The Board does not discriminate based upon age, race, creed, color, national origin, sexual orientation, gender identity or expression, religion, military or veteran status, sex, disability (including pregnancy-related conditions), predisposing genetic characteristics, familial status, marital status, status as a victim of domestic violence, or other applicable legally protected characteristics. The Board is dedicated to eliminating injustices and ensuring diversity in our workforce so we can better serve our staff and create a space where all feel safe to be themselves. To help meet those goals, we encourage applicants from marginalized communities to apply. We are looking for candidates who are committed to working in and contributing to an environment that fosters a sense of belonging, as well as inclusion, and celebrates people of all backgrounds, identities, experiences, and perspectives.
We are happy to provide reasonable accommodations during the hiring process. If you have a disability or special need that requires a reasonable accommodation, please send a request to
[email protected].
Some positions may require additional credentials or a background check to verify your identity.
