State Workers' Insurance Fund Claims Representative

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.

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.

QUALIFICATIONS

Minimum Experience and Training Requirements:

• Two years of clerical work experience that includes collecting, recording, compiling, or preparing documents for medical, health, or work-related insurance claims; or
• An equivalent combination of experience and training.

Additional Requirements:

• You must demonstrate the ability to adhere to the values and ethics of the Department of Labor and Industry.
• You must demonstrate the ability to work with professionalism, discretion, and good work ethic.
• You must have solid written and verbal communication skills.
• You must show initiative and problem-solving skills.
• You must be able to perform essential job functions.

How to Apply:

• Resumes, cover letters, and similar documents will not be reviewed, and the information contained therein will not be considered for the purposes of determining your eligibility for the position. Information to support your eligibility for the position must be provided on the application (i.e., relevant, detailed experience/education).
• If you are claiming education in your answers to the supplemental application questions, you must attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements. Unofficial transcripts are acceptable.
• Your application must be submitted by the posting closing date. Late applications and other required materials will not be accepted.
• Failure to comply with the above application requirements may eliminate you from consideration for this position.

Veterans:

Telecommunications Relay Service (TRS):

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.