WC Medical Claims Specialist Supervisor - 20068255

State of Ohio; Columbus (GA); On-site; Full time

Job summary

A state agency is seeking a WC Medical Claims Specialist Supervisor to oversee Medicare Subrogation processes and ensure compliance with billing procedures. The ideal candidate will have experience in claims management and provide leadership to processing staff. This full-time position offers a competitive hourly wage and opportunities for career growth within the agency.

Qualifications

• 24 months experience in private insurance organization as claims representative or similar.
• 6 months experience providing work direction to claims processing staff.

Responsibilities

• Direct responsibility over team processing Medicare Subrogation.
• Produce & maintain data for management reports of statistics.
• Monitors existing billing procedures and oversees implementation of new processes.

Skills

Attention to Detail

Leading Others

Teamwork

Education

Undergraduate program core coursework in business administration

Tools

Business

Insurance

Medical

Job description

Job Description - WC Medical Claims Specialist Supervisor - 20068255 (250003M9)

WC Medical Claims Specialist Supervisor - 20068255 ( 250003M9 )

Organization

Organization

: Workers' Compensation

Agency Contact Name and Information : [e-mail]

Unposting Date

Unposting Date

: May 15, 2025, 3:59:00 AM

Work Location

Work Location

: William Green Building 30 West Spring Street Columbus 43215-2256

Primary Location

Primary Location

: United States of America-OHIO-Franklin County-Columbus

Compensation : $30.96/hr.

Schedule

Schedule

: Full-time

Work Hours : 8:00am - 5:00pm

Union : Exempt from Union

Primary Job Skill

Primary Job Skill

: Claims Examination

Technical Skills : Business, Insurance, Medical

Professional Skills : Attention to Detail, Leading Others, Teamwork

Agency Overview

A Little About Us:
With roughly 1,500 employees in 7 offices across Ohio, BWC is the state agency that cares for Ohio workers by promoting a culture of safety at work and at home and ensuring quality medical and pharmacy care is provided to injured workers.
For Ohio employers, we provide insurance policies to cover workplace injuries and safety and wellness services to prevent injuries.

Our Culture:
BWC is a dynamic organization that offers career opportunities across many different disciplines. BWC employees strive to maintain an inclusive workplace. We begin by being an equal opportunity employer. Employees can participate in and lead employee resource groups, participate in online forums discussing society’s impact on our services and workplace, and learn about how different perspectives can improve leadership skills.

Our Vision:
To transform BWC into an agile organization driven by customer success.

Our Mission:
To deliver consistently excellent experiences for each BWC customer every day.

Our Core Values:
One Agency, Personal Connection, Innovative Leadership, Relentless Excellence.

What our employees have to say:
BWC conducts an internal engagement survey on an annual basis. Some comments from our employees include:

• BWC has been a great place to work as it has provided opportunities for growth that were lacking in my previous place of work.
• I have worked at several state agencies and BWC is the best place to work.
• Best place to work in the state and with a sense of family and support.
• I love the work culture, helpfulness, and acceptance I've been embraced with at BWC.
• I continue to be impressed with the career longevity of our employees, their level of dedication to service, pride in their work, and vast experience. It really speaks to our mission and why people join BWC and then retire from BWC.

Job Description

BWC’s core hours of operation are Monday-Friday from 8:00am to 5:00pm, however, daily start/end times may vary based on operational need across BWC departments. Most positions perform work on-site at one of BWC’s seven offices across the state. BWC offers flextime work schedules that allow an employee to start the day as early as 7:00am or as late as 8:30am. Flex-time schedules are based on operational need and require supervisor approval.

• Direct responsibility over team processing Medicare Subrogation (medical bill subrogation/disputes)
• Produce & maintain data for weekly/monthly management reports of statistics surrounding business activities and monitoring of staff performance
• Monitors existing billing procedures and oversees implementation of new/revised billing processes to ensure compliance with applicable laws, rules & regulations.
• Coordinates resolution of complex billing issues as they relate to medical billing payment and subrogation.
• Identify training opportunities and assist in development of training material

Qualifications

To Qualify, You MustClearlyDemonstrate:

Required Experience and/or Education:
Completion of undergraduate program core coursework in business administration or related field of study.

Or 24 mos. exp. in private insurance organization as claims representative, nurse, or rehabilitation specialist; 6 mos. exp. providing work direction to claims processing staff.

Or 24 mos. exp. in managing medical-only &/or lost-time claims, serving as primary decision maker to include making initial determination of claim, having overall responsibility & accountability of claims & management of claims to desired outcome.

Or 24 mos. exp. in supervisory level position within Ohio Bureau Of Workers' Compensation, 12 mos. of which involved telephoned, in-person &/or written contact with providers, claimants, employees, public officials, attorneys &/or general public to provide information & answer inquiries concerning various operations, services &/or policies & procedures of agency.

Or equivalent of Minimum Class Qualifications For Employment noted above.

Supplemental Information

EEO & ADA Statement:
The State of Ohio is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees due to protected classes as defined in applicable federal law, state law, and any effective executive order.

The Ohio Bureau of Workers' Compensation is committed to providing access and reasonable accommodation in its employment opportunities pursuant to the Americans with Disabilities Act and other applicable laws. To request a reasonable accommodation due to disability, please contact ADA Coordinator Kathleen Bourke at 614-644-7811 or by email to: [e-mail].

BWC OCSEA Selection Rights:
This position shall be filled in accordance with the provisions of the OCSEA Collective Bargaining Agreement. BWC bargaining unit members have selection rights before non-bargaining unit members. All other applications will only be considered if an internal bargaining unit applicant is not selected for this position.

Salary Information:
Hourly wage is expected to be paid at step 1 of the pay range associated with the position for candidates who are new employees of the state. Current employees of the state will be placed in the appropriate step based on any applicable union contract and/or requirements of the Ohio Revised Code. Movement to the next step of the pay range (a roughly 4% increase) will occur after six months, assuming job performance is acceptable. Thereafter, an employee will advance one step in the pay range every year until the highest step of the pay range is reached. There may also be possible cost of living adjustments (COLA) and longevity supplements begin after five (5) years of state service.

Transportation:
Position may require travel; therefore, persons occupying this position must be able to provide own transportation &/or legally operate a state-owned vehicle.

Educational Transcripts:
For any educational achievements to be considered during the screening process, you must at least attach an unofficial transcript that details the coursework you have completed.

All applicants must submit an Ohio Civil Service Application using the online Ohio Hiring Management System. Paper applications will not be accepted.

Background Check:
Prior to an offer of employment, the final applicant will be required to sign a background check authorization form and undergo a criminal background check. Criminal convictions do not necessarily preclude an applicant from consideration for a position.