Workers Compensation Specialist Grade 11

Minimum Qualifications:
Associate's Degree in business administration, risk management, insurance, or a related field required; supplemented by one year of experience performing specialized administrative duties involving medical billing review, processing of property/casualty insurance and/or worker's compensation claims; or any equivalent combination of education, training, and experience which provides the requisite knowledge, skills, and abilities for this job.
Specific License or Certification Required: None.
Specific Knowledge, Skills, or Abilities: Must be able to demonstrate proficiency in performance of the essential functions and learn, comprehend, and apply all county or departmental policies, practices, and procedures necessary to function effectively in the position.

Purpose of Classification:
The purpose of this classification is to perform duties related to providing specialized administrative support for the Workers' Compensation unit of the Risk Management Division. Responsibilities include conducting initial claims report intake/review for work-related accidents and on-the-job employee injuries, processing workers' compensation claim information for indemnity and/or medical benefit payments, maintaining files, and preparing injury/accident reports as required.
Essential Functions:
The following duties are normal for this position. The omission of specific statements of the duties does not exclude them from the classification if the work is similar, related, or a logical assignment for this classification. Other duties may be required and assigned.
Conducts initial claims report intake/review for work-related accidents and on-the-job employee injuries: receives Occupational Injury reports; verifies correct completion and assigns injury numbers; enters data into CS STARS; submits claim reports to the Safety Officer/Investigator for review and injury/accident investigation; and communicates authorizations for treatment to medical facilities.
Reviews/processes indemnity and/or medical benefits payments: ensures vendor payments are processed under the correct injury number and vendor code; checks for rejected or suspended payments; conducts research and resolves issues causing non-payments; and prepares payment vouchers for settlements involving bodily injury.
Composes, edits, and prepares correspondence and claims documents and conducts follow-up with medical service providers as required.
Identifies errors in claimant's payroll information or medical treatment schedule and advises the Workers' Compensation Supervisor of any discrepancies noted.
Interprets and explains County workers' compensation policies and procedures to internal and external customers: answers phone inquiries and provide information.
Maintains detailed filing systems containing confidential employee claims information, medical records, correspondence, and specialized reports and ensures that all supporting documentation is filed and maintained in accordance with applicable federal and state guidelines.
Provides administrative support to Workers' Compensation staff.
Additional Functions:
Performs other related duties as required.

Performance Aptitudes:
Data Utilization: Requires the ability to review, classify, categorize, prioritize, and/or analyze data. Includes exercising discretion in determining data classification, and in referencing such analysis to established standards for the purpose of recognizing actual or probable interactive effects and relationships.
Human Interaction: Requires the ability to work with and apply principles of persuasion and/or influence over others to coordinate programs or activities of a project, and resolve typical problems associated with the responsibilities of the job.
Equipment, Machinery, Tools, and Materials Utilization: Requires the ability to operate, maneuver and/or control the actions of equipment, machinery, tools, and/or materials used in performing essential functions.
Verbal Aptitude: Requires the ability to utilize a wide variety of reference, descriptive, and/or advisory data and information.
Mathematical Aptitude: Requires the ability to perform addition, subtraction, multiplication, and division; the ability to calculate decimals and percentages; the ability to utilize principles of fractions; and the ability to interpret graphs.
Functional Reasoning: Requires the ability to apply principles of rational systems; to interpret instructions furnished in written, oral, diagrammatic, or schedule form; and to exercise independent judgment to adopt or modify methods and standards to meet variations in assigned objectives.
Situational Reasoning: Requires the ability to exercise judgment, decisiveness and creativity in situations involving evaluation of information against measurable or verifiable criteria.

It is the policy of Fulton County that there will be equal opportunity for every citizen, employee and applicant, based upon merit without regard to race, color, religion, national origin, gender, age, genetics, disability or sexual orientation.