State Workers' Insurance Fund Claims Representative Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4826387) Apply  State Workers' Insurance Fund Claims Representative Salary $44,890.00 - $67,678.00 Annually Location Erie County, PA Job Type Non-Civil Service Permanent Full-time Job Number N-2025-18532 Department Department of Labor & Industry Division LI SWIF Erie Dstr Off Opening Date 02/13/2025 Closing Date 2/26/2025 11:59 PM Eastern Job Code 70350 Position Number 50273042 Union AFSCME Bargaining Unit G1 Pay Group ST05 Bureau / Division Code 00121641 Bureau / Division SWIF Erie District Office Worksite Address 448 West 11th Street, Suite B City Erie, Pennsylvania Zip Code 16501 Contact Name Felicia Newbury Contact Email fnewbury@pa.gov + Description + Benefits + Questions THE POSITION Are you interested in expanding your technical skills in the review, evaluation, and payment of workers’ compensation insurance claims? If so, consider joining the State Workers' Insurance Fund (SWIF) as a Claims Representative. This position gives you the opportunity to ensure compliance with applicable statute and claims administration practices, while approving payment claims and identifying claim issues. If you are an analytically minded professional with a keen eye for detail, we need you on our team! DESCRIPTION OF WORK As a Claims Representative, you will be tasked with completing investigations for reported incidents and claims, processing acceptance or denial within an established timeframe. Work involves determining if pre-existing conditions may impact a claim; identifying potential fraud; and making recommendations if excess use of physical therapy or medical equipment is identified. Effective communication is essential as you will have the opportunity to correspond with with claimants, employers, doctors, hospitals, and witnesses to determine eligibility for workers’ compensation benefits. You will also be responsible for monitoring claims, creating fact-based claims, and accurately completing all required forms. Additional responsibilities include: + Recommending use of Independent Medical Examinations (IME) + Issuing ongoing indemnity payments + Determining liability on all medical bills + Processing claim payment related vouchers Apply today and take your career up a notch with the Department of Labor & Industry! Interested in learning more? Additional details regarding this position can be found in the position description. (https://careers.employment.pa.gov/pd/PD\_NEOGOV.asp?p=50273042) Work Schedule and Additional Information: + Full-time employment + Work hours are 8:00 AM to 4:00 PM, Monday - Friday, with a 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 Erie. + 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. REQUIRED EXPERIENCE, TRAINING & ELIGIBILITY 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: + Pennsylvania law (51 Pa. C.S. §7103) provides employment preference for qualified veterans for appointment to many state and local government jobs. To learn more about employment preferences for veterans, go to www.employment.pa.gov/Additional%20Info/Pages/default.aspx and click the Veterans’ Preference tab or contact us at ra-cs-vetpreference@pa.gov . Telecommunications Relay Service (TRS): + 711 (hearing and speech disabilities or other individuals). 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. The Commonwealth is an equal employment opportunity employer and is committed to a diverse workforce. The Commonwealth values inclusion as we seek to recruit, develop, and retain the most qualified people to serve the citizens of Pennsylvania. The Commonwealth does not discriminate on the basis of race, color, religious creed, ancestry, union membership, age, gender, sexual orientation, gender identity or expression, national origin, AIDS or HIV status, disability, or any other categories protected by applicable federal or state law. All diverse candidates are encouraged to apply. Learn more about our Total Rewards by watching this shortvideo (https://www.youtube.com/embed/HtcSRnndflc?rel=0) ! See the total value of your benefits package by exploring ourbenefits calculator. Health & Wellness We offer multiple health plans so our employees can choose what works best for themselves and their families. Our comprehensive benefits package includes health coverage, vision, dental, and wellness programs.* Compensation & Financial Planning We invest in our employees by providing competitive wages and encouraging financial wellness by offering multiple ways to save money and ensure peace of mind including multiple retirement and investment plan options. Work/Life Balance We know there’s more to life than just work! Our generous paid leave benefits include paid vacation, paid sick leave, eight weeks of paid parental leave, military leave, and paid time off for most major U.S. holidays, as well as flexible work schedules and work-from-home opportunities.* Values and Culture We believe in the work we do and provide continual opportunities for our employees to grow and contribute to the greater good. As one of the largest employers in the state, we provide opportunities for internal mobility, professional development, and the opportunity to give back by participating in workplace charitable giving. Employee Perks Sometimes, it is the little “extras” that make a big difference. Our employees receive special employee-only discounts and rates on a variety of services and memberships. For more information on all of these Total Rewards benefits, please visitwww.employment.pa.gov and click on the benefits box. *Eligibility rules apply. 01 How many years of full-time clerical work experience that includes collecting, recording, compiling, or preparing documents for medical, health, or work-related insurance claims do you possess? + 2 years or more + 1 but less than 2 years + Less than 1 year + None 02 If you are claiming experience in the above question, please list the employer(s) where you gained this experience in the text box below. The employer(s) and a description of the experiencemustalso be included in the appropriate sections of your application if you would like the experience to be considered in the eligibility decision. If you claimed you do not have experience, type N/A in the text box below. 03 How much college coursework in any field of study have you completed? If you are claiming credits/degree, you must upload a copy of your college transcript(s) for this education to be considered in the eligibility decision. Unofficial transcripts are acceptable. You must attach your transcript(s) prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a transcript(s) to the application after it has been submitted. If your education was acquired outside of the United States, you must upload a copy of your foreign credential evaluation report. We can only accept foreign credential evaluations from organizations that are members of the National Association of Credential Services (NACES). A list of current NACES members can be found by visitingand clicking the Evaluation Services Link. For additional information on foreign education credentials, please visitand click on Other Information. You must attach your documentation prior to the submission of your application by using the "Attachments" tab on the left. You will not be able to add a document to the application after it has been submitted. + Associate's degree or higher + 30 but less than 60 credits + Less than 30 credits + None Required Question Employer Commonwealth of Pennsylvania Address 613 North Street Harrisburg, Pennsylvania, 17120 Website http://www.employment.pa.gov