USA
7 hours ago
Supervisory Workers' Compensation Claims Examiner
Summary This position is located in the Department of Labor (DOL), Office of Workers' Compensation Programs (OWCP), Division of Energy Employees Occupational Illness Compensation (DEEOIC), Medical Benefits Adjudication and Bill Processing (BMBABP), Medical Benefits Adjudication Unit (MBAU). The MBAU is responsible for the adjudication, Management and coordination of DEEOIC medical authorizations, medical bill audits, medical review, and quality assurance. Responsibilities Salary posted from lowest to highest pay scales, salary will be set based on location of selectee. This position is the outside the bargaining unit. For GS-0991-14, Supervisory Workers' Compensation Claims Examiner: As the senior technical expert in medical benefits and billing, the incumbent coordinates 6 supervisors, and devises new methods to establish and gather requirements, processes, and procedures for independent review audits with respect to data collection, data integrity, and data analysis in coordination with other senior staff. Serves as the technical authority in examining evidence and requests for compensable medical services and treatments for wide range of occupational illness. Collects, analyzes, and evaluates unit program data, which serves to increase the efficiency, effectiveness, and coherence of OWCP's medical benefits communities. Supervises subordinate supervisors of post initial adjudicatory medical benefits claims examiners. Acts as liaison between the BMBABP and the DEEOIC Director and Deputy Director and Branch Chief of Policy by representing and promoting the interests of DEEOIC. Generates qualitive reports to account for workload, timeliness, and deficiencies of work products. Directs, in coordination with other resources within the Branch, the preparation and presentation of materials requested by DOL Office of Inspector General (OIG) and the Government Accountability Office (GAO). Prepares and deliver briefings to senior officials; to influence stakeholders to accept and implement findings and recommendations within area of expertise; and to ensure that information provided to stakeholders is accurate and consistent. Requirements Conditions of Employment Qualifications IN DESCRIBING YOUR EXPERIENCE PLEASE BE CLEAR AND SPECIFIC, PLEASE USE THIS FORMAT MM/DD/YYYY WHEN DATING YOUR EXPERIENCE. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR SPECIALIZED EXPERIENCE, DATES OF EMPLOYMENT OR SALARY. You must meet the Specialized Experience to qualify for Supervisory Workers' Compensation Claims Examiner, as described below. For GS-14: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level GS-13 in the Federal Service. Specialized Experience is the experience that equipped the applicant with the particular knowledge, skills, and abilities (KSA's) to perform the duties of the position successfully, and that is typically in or related to the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level. Qualifying specialized experience for GS-15 includes: Applying regulations, policies or procedures while leading or directing staff of highly technical and complex medical, administrative, regulatory or policy development program or benefit program. Communicating technical information and presenting to internal and external customers with varying backgrounds to address concerns or resolve issues. Leading or directing units of claims examiners, medical benefits examiners, and/or medical billing staff regarding a highly technical and complex medical, administrative, regulatory benefits program to meet organizational goals and objectives. Adjudicating, reviewing or issuing decisions on highly complex cases for benefits based on evidence. Education This position does not have a positive education requirement. Additional Information This position is outside the bargaining unit. The mission of the Department of Labor (DOL) is to protect the welfare of workers and job seekers, improve working conditions, expand high-quality employment opportunities, and assure work-related benefits and rights for all workers. As such, the Department is committed to fostering a workplace and workforce that promote equal employment opportunity, reflects the diversity of the people we seek to serve, and models a culture of respect, equity, inclusion, and accessibility where every employee feels heard, supported, and empowered. Refer to these links for more information: GENERAL INFORMATION, REASONABLE ACCOMMODATION, ADDITIONAL DOCUMENTATION, FORMER FEDERAL EMPLOYEES As a condition of employment, all personnel must undergo a background investigation for access to DOL facilities, systems, information and/or classified materials before they can enter on duty: BACKGROUND INVESTIGATION You may not be aware, but in the regulations for agency ethics programs, there are requirements for supervisors. Section 2638.103 of Title 5 of the CFR states: Every supervisor in the executive branch has a heightened personal responsibility for advancing government ethics. It is imperative that supervisors serve as models of ethical behavior for subordinates. Supervisors have a responsibility to help ensure that subordinates are aware of their ethical obligations under the Standards of Conduct and that subordinates know how to contact agency ethics officials. Supervisors are also responsible for working with agency ethics officials to help resolve conflicts of interest and enforce government ethics laws and regulations, including those requiring certain employees to file financial disclosure reports. In addition, supervisors are responsible, when requested, for assisting agency ethics officials in evaluating potential conflicts of interest and identifying positions subject to financial disclosure requirements. Supervisory Financial Disclosure (If applicable): This position is subject to the confidential financial disclosure requirements of the Ethics in Government Act of 1978 (P.L. 95-521). Therefore, if selected, you will be required to complete a Confidential Financial Disclosure Report (OGE Form 450) to determine if a conflict or an appearance of a conflict exists between your financial interest(s) and your prospective position with DOL. This information will be required annually. Based on agency needs, additional positions may be filled using this vacancy. The Department of Labor may use certain incentives and hiring flexibilities, currently offered by the Federal government to attract highly qualified candidates. Click here for Additional Information. The Fair Chance Act (FCA) prohibits Federal agencies from requesting an applicant's criminal history information before the agency makes a conditional offer of employment. If you believe a DOL employee has violated your rights under the FCA, you may file a complaint of the alleged violation following our agency's complaint process Guidelines for Reporting Violations of the Fair Chance Act. Note: The FCA does not apply to some positions specified under the Act, such as law enforcement or national security positions. All Department of Labor employees are subject to the provisions of the Drug-Free Workplace Program under Executive Order 12564 and Public Law 100-71.
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