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This position of the Workers Compensation is responsible for auditing claims documents for compliance with applicable workers compensation claims management laws, statutes, and case laws.
This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures.
The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.
- Auditing 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 Average Monthly Wage.
- Having moderate amount of customer contact and repetitive review of recommended average monthly wage forms, performing review of calculations using internal software and tools to assist and approving/denying the request.
- Analyzing and issuing correct corresponding award, notification, or document.
- Answer incoming phone calls from injured workers, attorneys, interested parties, claim adjusters, medical providers, and the public.
- Matching documents lacking information to existing Commission claims files by researching information in Claims database and creating a new claim file for documents received when there is no existing claim file.
- Provide backup assistance to compliance, data entry, error resolution, no match or combine/delete as requested.
- Participating in Arizona Management System (AMS) and daily Huddle board.
- Attending staff meetings, seminars, conferences, training classes as required.
- Basic knowledge or ability to learn applicable workers compensation claims management laws, statutes, case laws.
- Basic Medical terminology.
- Basic Computer Navigation.
- Time Management.
- Microsoft Office Suite; Outlook, Word, Excel.
- Basic English.
- Basic Mathematics.
Skills in
- Remain focused through repetitive tasks.
- 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 skills
Ability to
- Manage heavy repetitive 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 frame.
- 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.
The ideal candidate for this position will have:
High School diploma, 5+ years of customer service experience and/or workers compensation insurance.
If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.
All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).
The Arizona Department of Administration offers a comprehensive benefits package to include:
Sick leave
Vacation with 10 paid holidays per year
Health and dental insurance
Retirement plan
Life insurance and long-term disability insurance
Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance
By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.
For a complete list of benefits provided by The State of Arizona, please visit our benefits page
You will be eligible to participate in the state employee health/disability insurance plan, and you are required to participate in the Arizona State Retirement System (ASRS). ASRS participation may begin immediately or upon your 27th week of employment. Contributions are matched by the employer.
If you have any questions please feel free to call 602-542-5559 or email HR@azica.gov for assistance.
