Assistant Insurance Fund Services Representative (NY HELPS)
: Job Details :

For new to NYS candidates OR current NYS employees (*NY HELPs Program): Four years of customer service experience that required independence in both verbal and written communication responsibilities; OR an associate degree or higher and two years of customer service experience that required independence in both verbal and written communication responsibilities.For current NYS employees only: One year of permanent, competitive class service in a title eligible for transfer under Section 70.1 of Civil Service Law. Eligible titles include, but are not limited to: Administrative Assistant 1, Business Document Specialist 2, Motor Vehicle Consumer Services Representative, Licensing Examiner 1, Taxpayer Services Representative 1, Program Aide, Payroll Examiner 1.Please be advised that the New York State Insurance Fund does not offer sponsorship for employment visas to employees or potential employees. Candidates sponsored for employment by an organization should be aware of their sponsorship status and the relevant expiration date(s) of that sponsorship before applying to this position. Duties Description •Review and process routine workers' compensation claims, including analysis and processing of payment of medical, compensation, and awards for assigned compensation claims. •Communicate with claimants, policyholders, medical providers, and various entities to gather information needed to process assigned work. Compile, maintain, and organize electronic claim files.•Process caseloads and work in designated systems to meet required deadlines that ensure the agency does not incur penalties. •Comply with appropriate form submission requirements and filing deadlines pursuant to applicable laws, regulations, and New York State Workers' Compensation Board processes and procedures governing workers' compensation claims cases. •Examine accident and medical reports to determine compensability and liability, seeking guidance and expertise as needed, and initiates proactive follow-ups for all updated information as needed. •Examine medical bills, authorize payments, and review and extend authorization for appropriate medical treatment based on medical facts contained in the file. •Maintain an understanding of the NYS Workers' Compensation Law, NYS COVID-19 legislation, and all other applicable New York State laws, rules, and regulations related to programmatic operations. •Gather supporting information for Section 32 settlements; and after supervisory review and approval of the settlement, process the settlement and closure of the claim. •Refer cases that may warrant investigation to supervisors. May prepare cases that are investigated for hearings. •Assess the initial and subsequent reserve estimates based upon the facts contained in the file for medical bills and compensation in consultation with supervisory staff. •Work with Policyholder Services to satisfy policyholder inquiries as to file status and reserve rationale. •Assess subrogation recovery potential and pursue accordingly. •Manage early return to work initiative in cooperation with policyholders, claimants, and physicians. •Keep complete records and internal controls utilizing a variety of internal systems. •Provide customer service to all claimants, policyholders, medical providers, and brokers, and internal agency staff, responding in a timely manner to all inquiries from any source including telephone, email, letter, and online inquiry.Additional Comments 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.Fringe Benefits: •Competitive Compensation.•Future Career Growth Potential. •Open and Supportive Team-Based Environment.•Plentiful Vacation, Personal, and Sick Leave Accruals. •Paid State and Federal Holidays.•Full Medical, Vision, and Dental. •Retirement Options. •Public Student Loan Forgiveness (PSLF).•Possibility of Telecommuting, Flextime, and Alternative Work Schedules.NY HELPS Program: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 a future date, 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 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.NYSIF Commitment to Diversity, Equity, and InclusionThe New York State Insurance Fund (NYSIF) prioritizes and champions diversity, equity, and inclusion (DEI) throughout our agency. NYSIF provides equal opportunities to all employees and applicants for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability, veteran status, or any other protected category under federal, state, and local law. We believe that embracing our differences brings richness, new ideas and experiences to NYSIF, which energizes a creative and innovative work environment. We strive to foster a workplace where diverse individuals are able to participate fully in the decision-making process and have ample opportunity for advancement. We are committed to investing the necessary resources and attention to improving the engagement, retention, and promotion of the extraordinary talent we have.Executive Order 31 commits New York State government to becoming a model employer for people with disabilities, increasing the participation of people with disabilities in state service and ensuring equal access to opportunities. NYSIF is proud to utilize best practices to recruit, hire, retain, and promote career advancement of individuals with disabilities. This includes special focus on current and prospective employees with the most significant disabilities, such as the use of supported employment, individual placement with support services, customized employment, the civil service sections 55/b and 55/c programs, internships, and job shadowing. If you are a person with a disability and wish to request that a reasonable accommodation be provided for you to participate in a job interview, please send an email to NYSIF's Reasonable Accommodations mailbox at ...@nysif.com. Some positions may require additional credentials or a background check to verify your identity.Name Paul Angelo Telephone Fax Email Address ...@nysif.com AddressStreet PO Box 66699 City Albany State NY Zip Code 12206 Notes on Applying Please email your resume and cover letter to ...@nysif.com with the Vacancy ID# referenced in the subject line. Please include your official Civil Service title within your application.