Claims Audit & Compliance Analyst - Workers' Comp

Division of Personnel Government of the VI; Charlotte Amalie (United States Virgin Islands); On-site; USD 35,000 - 55,000; Full time

Job summary

Division of Personnel Government of the VI seeks a position to review and audit Workers’ Compensation claimants’ files, under supervision of a higher-level officer. The role audits all vouchers for payment, files for medical recovery payments, and all expenditures related to the program.

Duties include verifying amounts payable, performing records checks from the Department of Finance, ensuring medical ceilings are respected, and preparing monthly expenditure statistics and case figures for the

Responsibilities

• Audits all orders and vouchers for payment to claimants, medical providers and institutions.
• Records checks when they arrive from the Department of Finance.
• Verifies that the amount is correct and is made payable to the correct claimant or provider.
• Audits files to ascertain that they do not go over the medically established on-island or off-island ceiling for medical treatment.
• Provides lien to attorneys for third party settlements.
• Verifies the calculation of third party settlements owned to Workers’ Compensation.
• Prepares various statistical and monthly reports of money expended by the Government Insurance Fund, total cases of injuries received, total questionable, numbers denied, and unusual cases received, along with other figures relative to the program.

Job description

Division of Personnel Government of the VI seeks a position to review and audit Workers’ Compensation claimants’ files, under supervision of a higher-level officer. The role audits all vouchers for payment, files for medical recovery payments, and all expenditures related to the program.

Duties include verifying amounts payable, performing records checks from the Department of Finance, ensuring medical ceilings are respected, and preparing monthly expenditure statistics and case figures for the