State of Michigan
Claims Examiner 9-P11
State of Michigan, Okemos, Michigan, United States, 48864
Claims Examiner 9-P11
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(https://www.governmentjobs.com/careers/michigan/jobs/newprint/4660741)
Apply
Claims Examiner 9-P11
Salary
$25.10 - $39.33 Hourly
Location
Okemos, MI
Job Type
Permanent Full Time
Remote Employment
Flexible/Hybrid
Job Number
1801-24-LA-WC-077
Department
LEO-Labor and Econ Opportunity
Opening Date
11/07/2024
Closing Date
11/20/2024 5:00 PM Eastern
Bargaining Unit
NON-EXCLUSIVE REPRESENTED EMPLOYEE (NERE)
+ Description
+ Benefits
+ Questions
Job Description
This position has been reposted. If you have already applied for the position, you do not need to reapply.
This position investigates and handles claims filed against the Funds Administration in accordance with the Workers' Disability Compensation Act, Administrative Rules, Trustee policy and applicable case law.
Perform as an investigator determining the validity of injured workers claims for benefits and eligibility for payment from the Self-Insurers' Security Fund (SISF) and Second Injury Fund/Permanent and Total Disability and Vocationally Handicapped Provisions.
Evaluate SISF and SIF claims for potential vocational rehabilitation or medical management and make necessary assignments of these tasks when warranted.
Perform assignments to our Special Assistant Attorneys General and Assistant Attorneys General for purpose of defense of our workers' compensation claims.
At the Department of Labor and Economic Opportunity, we are passionate about creating a positive, professional, and supportive work environment where we value our differences and are committed to being open and respectful to all our employees and the public we serve. Our department provides the connections, expertise, and innovative solutions to drive continued business growth, build vibrant communities, create affordable housing, generate tourism, and attract and retain key talent to fill Michigan's vast pipeline of opportunities. Learn more at www.michigan.gov/LEO.
Position Description (https://MCSC.state.mi.us/AgencyPDFs/Position Description Claims Examiner 9-P11.pdf)
Required Education and Experience
Education
Possession of a bachelor's degree with a major in business administration, insurance, or in a health-related field such as nursing, physician assistant, or pharmacy.
Experience
Claims Examiner 9
No specific type or amount is required.
Claims Examiner 10
One year of professional experience processing, reviewing and making determinations regarding medical insurance claims equivalent to a Claims Examiner 9.
Claims Examiner P11
Two years of professional experience processing, reviewing and making determinations regarding medical insurance claims equivalent to a Claims Examiner, including one year equivalent to a Claims Examiner 10.
Alternate Education and Experience
Claims Examiner 9
Educational level typically acquired through completion of high school and four years of experience in a Departmental Technician position reviewing and evaluating medical and compensation claims may be substituted for the education and experience requirements.
Additional Requirements and Information
Please attach a cover letter, detailed resume, and your official college transcript(s) to your application. For our purposes, "official college transcripts" must contain the college/university name and address, the degree conferred, date granted, coursework completed (especially if no degree granted), and the Registrar's signature and/or seal.A scanned or electronic copy is acceptable,if it contains the elements listed above. The college/university does not have to send the transcript directly to LEO.
For more information regarding official transcripts,click here (https://www.michigan.gov/documents/mdcs/OfficialTranscript\_693831\_7.pdf) .
Applicants who possess a degree from a foreign college or university must have their academic credentials evaluated or converted into U.S. educational equivalents unless the degree has been recognized by the Council on Higher Education Accreditation (CHEA).
Go toevaluators (https://www.naces.org/members) for a list of accepted organizations that evaluate foreign credentials.
Failure to provide this evaluation at the time of application may result in you being screened out of the process.
Information provided in your application, resume, cover letter, transcripts, and any other documentation provided will be used to verify responses to the supplemental questions. Unsupported responses may not be considered further.
All classified employees are subject to Civil Service Rule 2-8 Ethical Standards and Conductand will be expected to disclose any personal and financial interests that may conflict with official duties as a classified employee.
All newly hired state employees are required to submit and pass a pre-employment drug test prior to their actual appointment. Certain positions within the Michigan Department of Labor and Economic Opportunity may also require state criminal, fingerprint-based and driving record background checks. Any position offer will be conditional until results of the background checks and drug test indicate eligibility for employment.
The Michigan Department of Labor and Economic Opportunity participates inE-Verify (https://www.e-verify.gov/employees/employee-rights-and-responsibilities) and will provide the federal government with your form I-9 information to confirm that you are authorized to work in the U.S.
Applications must be submitted through NEOGOV. If you have questions or need assistance uploading and/or attaching your documents, please contact the NEOGOV applicant support at 855-524-5627.
View the entire job specification at:
https://www.michigan.gov/mdcs/-/media/Project/Websites/mdcs/JOBSPECS/C/ClaimsExaminer.pdf
Accommodations
If you require a reasonable accommodation to participate in the application or selection processes, please contact theADA coordinator (https://www.michigan.gov/ose/-/media/Project/Websites/ose/Contact/RACs.pdf) for the agency that posted this position vacancy.
State employment also offers rewarding careers where you can help Michiganders enjoy better lives. Many State of Michigan jobs offer alternate work schedules and remote-work options that can help give the flexibility you need. The State of Michigan has been recognized as a leading U.S. employer by new graduates from 2021-2023 and a best large U.S. and state employer. Recognized on the international stage for fostering positive employee engagement, the State of Michigan is a past recipient of a North America Government Agency Employees Engagement Award.
More details on benefits for our new hires are below:
Rewarding Work:State of Michigan jobs allow you to serve Michiganders in many different ways depending on your interests and skills. Help preserve and protect our environment and the public health; enforce state laws and regulations; advocate for children, families, and victims of discrimination; support our state's military and veterans; rebuild our state's infrastructure; or support other state agencies through our fiscal, IT, and HR systems.
Insurance Benefits:The State of Michigan offers health, mental health, dental, and vision insurance to eligible career employees, their spouses, and their children. The state also covers a life-insurance benefit of two times employees' annual salary (up to $200,000). The state also offers long-term-disability insurance that can provide continuing benefits if an injury or illness prevents employees from working. More information is available at www.mi.gov/employeebenefits.
Retirement Programs:The State of Michigan offers 401(k) and 457 plans for new hires to save for retirement. The state will automatically contribute an amount equal to 4% of your pay to a 401(k) account. The state will also match up to 5% of your pay if you contribute to your 401(k) account. Your contributions vest immediately, and the state's contributions fully vest after just 4 years. More information is available athttp://www.mi.gov/orsstatedc.
Vacation and Sick Leave:Eligible full-time employees receive between15 and 35 personal daysand 13 sick daysper year that may be rolled over to the following year if not used. Eligible employees also receive an additional day each year for community service or school functions.
Paid Parental Leave:Eligible employees can take 12 weeks of paid leaveimmediately after a birth or adoption to allow needed time together at home with a new child.
Paid Holidays:Eligible employees receive 13 or 14 paid holidays each year including New Year's Eve and Day, Martin Luther King Jr. Day, Presidents' Day, Memorial Day, Juneteenth, the Fourth of July, Labor Day, Election Day, Veterans Day, Thanksgiving, Thanksgiving Friday, Christmas Eve and Day.
Bonus Programs:Eligible employees with five years of service also receive annual longevity bonuses that grow as seniority increases. Some positions also may qualify for recruitment, retention, and performance bonuses or other special pay premiums.
Military Pay Differential:Employees in the guard or reserves may also qualify for supplemental pay benefits if miliary pay during qualifying duty is less than normal state pay. Prior military service may also allow seniority credits to accelerate eligibility for longevity bonuses and additional personal leave accrual.
Tax-Advantaged Programs:In addition to 401(k) and 457 retirement accounts, the state also offers flexible spending account (FSA), health savings account (HSA), and qualified transportation fringe benefit (QTFB) programs that can help you save money by reducing your taxable income.
Student Loan Forgiveness:Working for the State of Michigan may allow you to participate in programs that forgive the balance of qualifying student loans. Information (https://studentaid.gov/manage-loans/forgiveness-cancellation) to help determine if you could qualify is available from the U.S. Department of Education.
Tuition Reduction:Some colleges and universities offer savings to eligible employees and family members to further their education while working for the State of Michigan.
Professional Development: To help develop your career, programs are available to apply for reimbursement of up to $2,000 a year for education and training for college course credits and non-degree programs.
Alternative and Remote Work Schedules:Depending on the nature of their duties, many state jobs offer flexible work schedules and remote or hybrid telecommuting options that can help obtain the work-life balance that you seek.
Great Lakes and Great Times:Michigan boasts four Great Lakes, 11,000 inland lakes, 36,000 miles of rivers and streams, 20 million acres of forests, 100 state and national parks and recreation areas, 1,300 miles of bike trails, 6,500 miles of snowmobile trails, the second-most ski areas in the nation, 650 public golf courses, 600 campgrounds, and an international dark-sky park-just for starters. Our cities offer concerts and cultural events, storied sports teams, education hubs, vibrant downtowns, one-of-a-kind craft beverages, and renowned restaurants for every appetite. From urban centers to beach towns to the great outdoors, the opportunities are endless. With your state salary and benefits and Michigan's affordable cost of living, you can explore all that Michigan has to offer.
Updated: 2/28/24
01
CLAMEXM - Do you possess one of the following? -A bachelor's degree or higher with a major in business administration, insurance, or in a health-related field such as nursing, physician assistant, or pharmacy. OR, -At least an educational level typically acquired through completion of high school and four years of experience in a Departmental Technician position reviewing and evaluating medical and compensation claims.
+ Yes
+ No
02
CLAMEXM - Please select your level of experience.
+ None to one year of professional experience processing, reviewing and making determinations regarding medical insurance claims.
+ One to two years of professional experience processing, reviewing and making determinations regarding medical insurance claims.
+ Two to three years of professional experience processing, reviewing and making determinations regarding medical insurance claims.
+ At least three years of professional experience processing, reviewing and making determinations regarding medical insurance claims.
03
Do you have any knowledge of the Workers' Disability Compensation Act and Administrative Rules and case law pertaining to workers' disability compensation?
+ Yes
+ No
04
If you answered yes to the previous question, please explain your experience. If none, please type N/A.
05
Are you related to anyone working at the agency in which you are seeking employment? If yes, please list the name of each relative.
06
Please select the years of experience handling workers disability compensation claims.
+ None to one year
+ One to two years
+ Two to Three years
+ At least three years
07
Please explain the experience indicated in the previous question. If none, please type N/A
08
1801- From the options below, which accurately describes your current status? (A current State employee works for an actual State Department such as Department of Corrections (MDOC), Department of Transportation (MDOT) etc.)
+ Not a State of Michigan employee
+ A previous State of Michigan employee
+ A current State of Michigan, Department of Labor & Economic Opportunity (LEO) employee
+ A current State of Michigan (non-LEO) employee
09
Did you attach a cover letter, copy of your resume and transcripts to your application? (Failure to do so may result in your application being screened out).
+ Yes
+ No
Required Question
Agency
State of Michigan
Department
LEO-Labor and Econ Opportunity
Address
leo-ohr@michigan.gov
PO Box 30714
Lansing, Michigan, 48909
Phone
517-241-9868
Website
https://www.michigan.gov/leo
Apply
Please verify your email addressVerify Email
(https://www.governmentjobs.com/careers/michigan/jobs/newprint/4660741)
Apply
Claims Examiner 9-P11
Salary
$25.10 - $39.33 Hourly
Location
Okemos, MI
Job Type
Permanent Full Time
Remote Employment
Flexible/Hybrid
Job Number
1801-24-LA-WC-077
Department
LEO-Labor and Econ Opportunity
Opening Date
11/07/2024
Closing Date
11/20/2024 5:00 PM Eastern
Bargaining Unit
NON-EXCLUSIVE REPRESENTED EMPLOYEE (NERE)
+ Description
+ Benefits
+ Questions
Job Description
This position has been reposted. If you have already applied for the position, you do not need to reapply.
This position investigates and handles claims filed against the Funds Administration in accordance with the Workers' Disability Compensation Act, Administrative Rules, Trustee policy and applicable case law.
Perform as an investigator determining the validity of injured workers claims for benefits and eligibility for payment from the Self-Insurers' Security Fund (SISF) and Second Injury Fund/Permanent and Total Disability and Vocationally Handicapped Provisions.
Evaluate SISF and SIF claims for potential vocational rehabilitation or medical management and make necessary assignments of these tasks when warranted.
Perform assignments to our Special Assistant Attorneys General and Assistant Attorneys General for purpose of defense of our workers' compensation claims.
At the Department of Labor and Economic Opportunity, we are passionate about creating a positive, professional, and supportive work environment where we value our differences and are committed to being open and respectful to all our employees and the public we serve. Our department provides the connections, expertise, and innovative solutions to drive continued business growth, build vibrant communities, create affordable housing, generate tourism, and attract and retain key talent to fill Michigan's vast pipeline of opportunities. Learn more at www.michigan.gov/LEO.
Position Description (https://MCSC.state.mi.us/AgencyPDFs/Position Description Claims Examiner 9-P11.pdf)
Required Education and Experience
Education
Possession of a bachelor's degree with a major in business administration, insurance, or in a health-related field such as nursing, physician assistant, or pharmacy.
Experience
Claims Examiner 9
No specific type or amount is required.
Claims Examiner 10
One year of professional experience processing, reviewing and making determinations regarding medical insurance claims equivalent to a Claims Examiner 9.
Claims Examiner P11
Two years of professional experience processing, reviewing and making determinations regarding medical insurance claims equivalent to a Claims Examiner, including one year equivalent to a Claims Examiner 10.
Alternate Education and Experience
Claims Examiner 9
Educational level typically acquired through completion of high school and four years of experience in a Departmental Technician position reviewing and evaluating medical and compensation claims may be substituted for the education and experience requirements.
Additional Requirements and Information
Please attach a cover letter, detailed resume, and your official college transcript(s) to your application. For our purposes, "official college transcripts" must contain the college/university name and address, the degree conferred, date granted, coursework completed (especially if no degree granted), and the Registrar's signature and/or seal.A scanned or electronic copy is acceptable,if it contains the elements listed above. The college/university does not have to send the transcript directly to LEO.
For more information regarding official transcripts,click here (https://www.michigan.gov/documents/mdcs/OfficialTranscript\_693831\_7.pdf) .
Applicants who possess a degree from a foreign college or university must have their academic credentials evaluated or converted into U.S. educational equivalents unless the degree has been recognized by the Council on Higher Education Accreditation (CHEA).
Go toevaluators (https://www.naces.org/members) for a list of accepted organizations that evaluate foreign credentials.
Failure to provide this evaluation at the time of application may result in you being screened out of the process.
Information provided in your application, resume, cover letter, transcripts, and any other documentation provided will be used to verify responses to the supplemental questions. Unsupported responses may not be considered further.
All classified employees are subject to Civil Service Rule 2-8 Ethical Standards and Conductand will be expected to disclose any personal and financial interests that may conflict with official duties as a classified employee.
All newly hired state employees are required to submit and pass a pre-employment drug test prior to their actual appointment. Certain positions within the Michigan Department of Labor and Economic Opportunity may also require state criminal, fingerprint-based and driving record background checks. Any position offer will be conditional until results of the background checks and drug test indicate eligibility for employment.
The Michigan Department of Labor and Economic Opportunity participates inE-Verify (https://www.e-verify.gov/employees/employee-rights-and-responsibilities) and will provide the federal government with your form I-9 information to confirm that you are authorized to work in the U.S.
Applications must be submitted through NEOGOV. If you have questions or need assistance uploading and/or attaching your documents, please contact the NEOGOV applicant support at 855-524-5627.
View the entire job specification at:
https://www.michigan.gov/mdcs/-/media/Project/Websites/mdcs/JOBSPECS/C/ClaimsExaminer.pdf
Accommodations
If you require a reasonable accommodation to participate in the application or selection processes, please contact theADA coordinator (https://www.michigan.gov/ose/-/media/Project/Websites/ose/Contact/RACs.pdf) for the agency that posted this position vacancy.
State employment also offers rewarding careers where you can help Michiganders enjoy better lives. Many State of Michigan jobs offer alternate work schedules and remote-work options that can help give the flexibility you need. The State of Michigan has been recognized as a leading U.S. employer by new graduates from 2021-2023 and a best large U.S. and state employer. Recognized on the international stage for fostering positive employee engagement, the State of Michigan is a past recipient of a North America Government Agency Employees Engagement Award.
More details on benefits for our new hires are below:
Rewarding Work:State of Michigan jobs allow you to serve Michiganders in many different ways depending on your interests and skills. Help preserve and protect our environment and the public health; enforce state laws and regulations; advocate for children, families, and victims of discrimination; support our state's military and veterans; rebuild our state's infrastructure; or support other state agencies through our fiscal, IT, and HR systems.
Insurance Benefits:The State of Michigan offers health, mental health, dental, and vision insurance to eligible career employees, their spouses, and their children. The state also covers a life-insurance benefit of two times employees' annual salary (up to $200,000). The state also offers long-term-disability insurance that can provide continuing benefits if an injury or illness prevents employees from working. More information is available at www.mi.gov/employeebenefits.
Retirement Programs:The State of Michigan offers 401(k) and 457 plans for new hires to save for retirement. The state will automatically contribute an amount equal to 4% of your pay to a 401(k) account. The state will also match up to 5% of your pay if you contribute to your 401(k) account. Your contributions vest immediately, and the state's contributions fully vest after just 4 years. More information is available athttp://www.mi.gov/orsstatedc.
Vacation and Sick Leave:Eligible full-time employees receive between15 and 35 personal daysand 13 sick daysper year that may be rolled over to the following year if not used. Eligible employees also receive an additional day each year for community service or school functions.
Paid Parental Leave:Eligible employees can take 12 weeks of paid leaveimmediately after a birth or adoption to allow needed time together at home with a new child.
Paid Holidays:Eligible employees receive 13 or 14 paid holidays each year including New Year's Eve and Day, Martin Luther King Jr. Day, Presidents' Day, Memorial Day, Juneteenth, the Fourth of July, Labor Day, Election Day, Veterans Day, Thanksgiving, Thanksgiving Friday, Christmas Eve and Day.
Bonus Programs:Eligible employees with five years of service also receive annual longevity bonuses that grow as seniority increases. Some positions also may qualify for recruitment, retention, and performance bonuses or other special pay premiums.
Military Pay Differential:Employees in the guard or reserves may also qualify for supplemental pay benefits if miliary pay during qualifying duty is less than normal state pay. Prior military service may also allow seniority credits to accelerate eligibility for longevity bonuses and additional personal leave accrual.
Tax-Advantaged Programs:In addition to 401(k) and 457 retirement accounts, the state also offers flexible spending account (FSA), health savings account (HSA), and qualified transportation fringe benefit (QTFB) programs that can help you save money by reducing your taxable income.
Student Loan Forgiveness:Working for the State of Michigan may allow you to participate in programs that forgive the balance of qualifying student loans. Information (https://studentaid.gov/manage-loans/forgiveness-cancellation) to help determine if you could qualify is available from the U.S. Department of Education.
Tuition Reduction:Some colleges and universities offer savings to eligible employees and family members to further their education while working for the State of Michigan.
Professional Development: To help develop your career, programs are available to apply for reimbursement of up to $2,000 a year for education and training for college course credits and non-degree programs.
Alternative and Remote Work Schedules:Depending on the nature of their duties, many state jobs offer flexible work schedules and remote or hybrid telecommuting options that can help obtain the work-life balance that you seek.
Great Lakes and Great Times:Michigan boasts four Great Lakes, 11,000 inland lakes, 36,000 miles of rivers and streams, 20 million acres of forests, 100 state and national parks and recreation areas, 1,300 miles of bike trails, 6,500 miles of snowmobile trails, the second-most ski areas in the nation, 650 public golf courses, 600 campgrounds, and an international dark-sky park-just for starters. Our cities offer concerts and cultural events, storied sports teams, education hubs, vibrant downtowns, one-of-a-kind craft beverages, and renowned restaurants for every appetite. From urban centers to beach towns to the great outdoors, the opportunities are endless. With your state salary and benefits and Michigan's affordable cost of living, you can explore all that Michigan has to offer.
Updated: 2/28/24
01
CLAMEXM - Do you possess one of the following? -A bachelor's degree or higher with a major in business administration, insurance, or in a health-related field such as nursing, physician assistant, or pharmacy. OR, -At least an educational level typically acquired through completion of high school and four years of experience in a Departmental Technician position reviewing and evaluating medical and compensation claims.
+ Yes
+ No
02
CLAMEXM - Please select your level of experience.
+ None to one year of professional experience processing, reviewing and making determinations regarding medical insurance claims.
+ One to two years of professional experience processing, reviewing and making determinations regarding medical insurance claims.
+ Two to three years of professional experience processing, reviewing and making determinations regarding medical insurance claims.
+ At least three years of professional experience processing, reviewing and making determinations regarding medical insurance claims.
03
Do you have any knowledge of the Workers' Disability Compensation Act and Administrative Rules and case law pertaining to workers' disability compensation?
+ Yes
+ No
04
If you answered yes to the previous question, please explain your experience. If none, please type N/A.
05
Are you related to anyone working at the agency in which you are seeking employment? If yes, please list the name of each relative.
06
Please select the years of experience handling workers disability compensation claims.
+ None to one year
+ One to two years
+ Two to Three years
+ At least three years
07
Please explain the experience indicated in the previous question. If none, please type N/A
08
1801- From the options below, which accurately describes your current status? (A current State employee works for an actual State Department such as Department of Corrections (MDOC), Department of Transportation (MDOT) etc.)
+ Not a State of Michigan employee
+ A previous State of Michigan employee
+ A current State of Michigan, Department of Labor & Economic Opportunity (LEO) employee
+ A current State of Michigan (non-LEO) employee
09
Did you attach a cover letter, copy of your resume and transcripts to your application? (Failure to do so may result in your application being screened out).
+ Yes
+ No
Required Question
Agency
State of Michigan
Department
LEO-Labor and Econ Opportunity
Address
leo-ohr@michigan.gov
PO Box 30714
Lansing, Michigan, 48909
Phone
517-241-9868
Website
https://www.michigan.gov/leo
Apply
Please verify your email addressVerify Email