CLAIMS EXAMINER WORKMENS COMPENSATION
DEFINITION
Under direction, receives accident reports for all municipal
employees and makes tentative determinations as to eligibility
for Workers Compensation in accord with the statutes of the State
of New Jersey governing Workers Compensation and municipal
regulations concerning local employees; reviews, checks, and
certifies reports and applications; prepares and maintains
records and files; does other related duties as required.
NOTE: The definition and examples of work for this title
are for illustrative purposes only. A particular position using this
title may not perform all duties listed in this job specification.
Conversely, all duties performed on the job may not be listed.
EXAMPLES OF WORK:
Receives and processes all accident reports for all municipal
employees.
Reviews, checks, and certifies reports, applications, and other
documents for correctness.
Interviews and transacts routine business with persons who may
call at the office.
Compiles statistical and other data.
Reviews and adjusts complaints.
Prepares and verifies bills.
Handles routine correspondence.
Approves for payment and processes medical bills and any
additional claims relating to Workers Compensation claims.
Verifies accuracy of all bills and medical reports before clearance for
payment.
Contacts doctors, hospitals, and companies to whom
payment is due to check the status of bills, advise them of
errors, and request corrected bills.
Posts invoice of payments and gathers all data pertinent to
compensation claims.
Refers claimants to various municipal doctors for examination.
Establishes and maintains a ledger of all court compensation
cases with complete cost to the municipality.
Gathers data for compensation cases.
Enters documents from various forms of copy into computer systems
Will be required to learn to utilize various types of electronic
and/or manual recording and information systems used by the
agency, office, or related units.
REQUIREMENTS:
EXPERIENCE:
Two(2) years of experience in work involving conducting interviews,
computing figures, and verifying claims.
LICENSE:
Appointees will be required to possess a driver's license
valid in New Jersey only if the operation of a vehicle, rather
than employee mobility, is necessary to perform the essential
duties of the position.
KNOWLEDGE AND ABILITIES:
Knowledge of methods used to conduct interviews.
Knowledge of basic mathematic principles.
Knowledge of methods used to verify information
Knowledge of Statutes of the State of New Jersey governing
Workers Compensation and municipal regulations concerning local
employees after a period of training.
Knowledge of office methods, practices, and equipment.
Ability to organize and develop efficient work methods.
Ability to maintain essential records and files.
Ability to learn to utilize various types of electronic and/or
manual recording and information systems used by the agency,
office, or related units.
Ability to read, write, speak, understand, or communicate in
English sufficiently to perform the duties of this position.
American Sign Language or Braille may also be considered as
acceptable forms of communication.
Persons with mental or physical disabilities are eligible as
long as they can perform the essential functions of the job after
reasonable accommodation is made to their known limitations. If
the accommodation cannot be made because it would cause the
employer undue hardship, such persons may not be eligible.
