(3) Technical Claims Specialist - 20067691, 20068268, 20069838
(240002ZV) A Little About Us
With roughly 1,600 employees in 11 offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers.
For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.
Our Culture:
BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC employees strive to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee resource groups, participate in online forums discussing society’s impact on our services and workplace, and learn about how different perspectives can improve leadership skills.
Our Vision:
To transform BWC into an agile organization driven by customer success.
Our Mission:
To deliver consistently excellent experiences for each BWC customer every day.
Our Core Values:
One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.
What our employees have to say:
BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:
- I have worked for BWC for 27 years and it has been a positive experience.
- I have worked with a wonderful group of people from management down to my co-workers.
- So much opportunity for growth here, the leadership from top to bottom is stellar, the employees have pride in our agency - a great place to work!
- Coming up on 30 years and still love what I do and where I work!
- I find BWC to be a dynamic agency that not only provides a much-needed public service, but also has a culture of learning and development where employees are encouraged to be a part of the agency as a whole.
If you are interested in helping BWC grow, please click this link to read more, and then come back to this job posting to submit your application!
BWC is currently operating under a hybrid schedule that may incorporate both teleworking and in-person office hours. Employees must be able to report to the office when requested by management &/or for their initial job training.
BWC Operations Division is hiring for three (3) Operations Quality Assurance Auditors (Technical Claims Specialists).
What You'll Do:
- Conduct Operations Division quality assurance reviews
- Coordinates updates of claim review questions and QHelp
- Identifies trends and follows-up with Operations staff; identifies positive & negative trends within service offices to achieve improved customer satisfaction;
- Recommends improvement measures to Operations Management regarding necessary changes in operations in order to improve overall quality and consistency of services provided & increase efficiency;
- Collaborates with operations administration staff and Operational Policy to ensure continuity of knowledge and provision of services at all times
- Communicates effectively with internal and external customers at all levels
At the State of Ohio, we take care of the team that cares for Ohioans. We provide a variety of quality, competitive benefits to eligible full-time and part-time employees. For a list of all the State of Ohio Benefits, visit our Total Rewards website! Our benefits package includes:
Medical Coverage
- Quality, affordable, and competitive medical benefits are offered through the available Ohio Med plans.
Dental, Vision and Basic Life Insurance
- Dental, vision, and basic life insurance premiums are free after completed eligibility period. Length of eligibility period is dependent on union representation.
Time Away From Work and Work/Life Balance
- Paid time off, including vacation, personal, and sick leave
- 11 paid holidays per year
- Childbirth/Adoption leave
Employee Development Funds
- The State of Ohio offers a variety of educational and professional development funding that varies based on whether you are a union-exempt employee or a union-represented employee.
Ohio Public Employees Retirement System
- OPERS is the retirement system for State of Ohio employees. The employee contributes 10% of their salary towards their retirement. The employer contributes an amount equal to 14% of the employee’s salary. Visit the OPERS website for more information.
Deferred Compensation
- The Ohio Deferred Compensation program is a 457(b) voluntary retirement savings plan. Visit the Ohio Deferred Compensation website for more information.
To Qualify, You Must Clearly Demonstrate:
Required Experience and/or Education:
- Or 2 yrs. trg. or 2 yrs. exp. in adjusting insurance claims or medical case management in insurance-related field, or rehabilitation case management in insurance related field; 1 course or 3 mos. exp. in employee training & development; 2 courses or 6 mos. exp. in public speaking or communication skills; 1 course or 3 mos. exp. in business/professional writing, English composition or written communication.
- Or completion of undergraduate core program in business administration, public administration, insurance, risk management, education, communication, social or behavioral science, nursing or health administration (e.g., rehabilitation counseling) or related field of study; 1 course or 3 mos. exp. in auditing principles & procedures; 1 course or 3 mos. exp. in employee training & development; 1 course or 3 mos. exp. in speech &/or oral communication or public speaking; 1 course or 3 mos. exp. in business/professional writing, English composition, or written communication.
- Or 36 mos. exp. as supervisor within Ohio Bureau of Workers' Compensation responsible for implementation, evaluation & monitoring of technical programs (e.g., new or revised claims processing program, programs to identify & deter fraudulent claims activity, premium discount program).
- Or equivalent of Minimum Class Qualifications for Employment noted above.
Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services, activities, programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.
The State of Ohio is a drug-free workplace which prohibits the use of marijuana (recreational marijuana/non-medical cannabis). Please note, this position may be subject to additional restrictions pursuant to the State of Ohio Drug-Free Workplace Policy (HR-39), and as outlined in the posting.
Knowledge of workers' compensation laws, policies & procedures; eligibility criteria & workers' compensation claims processing procedures; medical terminology; accounting; auditing; employee training & development; public speaking or effective communication skills; insurance claim management & negotiation techniques. Skill in operation of video display terminal or personal computer*. Ability to deal with many variables & determine specific action; write instructions, specifications & technical manuals regarding operations policy & procedures; gather, collate, classify, analyze & interpret information about data, people or things; handle sensitive & confidential inquiries & contacts. (*)Developed after employment.
Salary Information:
Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state. Current employees of the state will be placed in the appropriate step based on any applicable union contract and/or requirements of the Ohio Revised Code. Movement to the next step of the pay range will occur after six months, assuming job performance is acceptable. Thereafter, an employee will advance one step in the pay range every year until the highest step of the pay range is reached. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service.
Educational Transcript Requirement
In order for any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed.
Transportation:
Position may require travel; therefore, persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.
Required Background Check
Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.
EEO & ADA Statement:
The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order.
The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request a reasonable accommodation due to disability, please contact ADA Coordinator Kathleen Bourke at 614-644-7811 or by email to: eeodept@bwc.state.oh.us.
All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.