WORKERS’ COMPENSATION CLAIMS FACILITATOR - WAILUKU, MAUI

State of Hawai'i; Hawaii; On-site; USD 57,000 - 69,000; Full time

Job summary

The State of Hawai'i DLIR seeks a full-time employee in Wailuku, Maui to promote understanding and facilitate the resolution of workers’ compensation claims. You will explain laws, rules, benefits, and the claims process to claimants, employers, physicians, attorneys, and insurers.

A bachelor’s degree is required, plus 1.5 years of specialized workers’ compensation experience, strong writing skills, and the ability to write clear reports and communicate effectively.

Qualifications

• Requires strong written and oral communication abilities and the capacity to prepare clear correspondence and reports.
• Experience interpreting and explaining workers' compensation laws, rules, and benefits.
• Ability to assess and solve problems, and to interact effectively with claimants, employers, and insurers.

Responsibilities

• Explain workers' compensation laws, rules, benefits, and the claims processes to claimants, employers, physicians, attorneys, and insurers.
• Respond to complaints and facilitate resolution of conflicts in claims proceedings.
• Prepare clear and concise reports and documentation for case management.

Skills

Communication skills

Report writing

Interpersonal skills

Education

Bachelor's degree

Job description

Recruitment Number DLIR-2027-011 - Position is full-time and located in Wailuku, Maui.

Salary: $5,107 to $6,221 monthly (SR-20, Step D to I)

Hiring rates will be based on availability of funds, the applicant's qualifications, and other relevant factors.

This class reflects responsibility for serving as an intermediary to promote understanding and facilitate the resolution of conflicts which arise during the workers' compensation claims process. The work involves responding to complaints from claimants, employers, physicians, attorneys, and representatives from insurance companies; explaining worker's compensation laws, rules and benefits, and the claims, hearing and appeal processes; explaining the implications that various courses of action may have on a case; securing the cooperation of parties to submit documentation required in order for the case to proceed further; identifying conflicts between award limits prescribed by laws and rules and requested awards; and whenever possible, encouraging the parties to resolve the claim.

TO qualify, you must meet all of the following requirements:

LEGAL AUTHORIZATION TO WORK:

The State of Hawaii requires all persons seeking employment with the government of the State shall be citizens, nationals, or permanent resident aliens of the United States, or eligible under federal law for unrestricted employment in the United States.

Applicants must meet all the requirements for the position they are seeking as of the date of the application, unless otherwise specified. Please note that unless specifically indicated, the required education and experience may not be gained concurrently.

Applicants must meet all the requirements for the position they are seeking as of the date of the application, unless otherwise specified. Please note that unless specifically indicated, the required education and experience may not be gained concurrently.

Your possession of the required amount of experience will not in itself be accepted as proof of qualification for the position. Overall paid or unpaid experience must be of such scope and responsibility as to conclusively demonstrate that you have the ability to perform the duties of the position.

Note: Your calculation of experience must be based on full-time, 40-hour work weeks. Part-time experience must be pro-rated. Example: Twelve (12) months of experience at 20 hours/week is equivalent to six (6) months of experience, not one (1) year. Also, hours worked in excess of 40 hours/week will not be credited. Example: Twelve (12) months of experience at 60 hours/week is equivalent to one (1) year of experience, not one and a half (1 ½) years.

BASIC EDUCATION REQUIREMENT

Graduation from an accredited four (4) year college or university with a bachelor's degree.

Excess work experience as described under the Specialized Experience, below, or any other responsible administrative, professional or analytical work experience that provided knowledge, skills and abilities comparable to those acquired in four (4) years of successful study while completing a college or university curriculum leading to a baccalaureate degree may be substituted on a year-for-year basis. To be acceptable, the experience must have been of such scope, level and quality as to assure the possession of comparable knowledge, skills and abilities.

The education or experience background must also demonstrate the ability to write clear and comprehensive reports and other documents; read and interpret complex written material; and solve complex problems logically and systematically.

SPECIALIZED EXPERIENCE REQUIREMENT

One and a half (1 ½) years of progressively responsible professional work experience in the area of workers’ compensation including case management which demonstrated the ability to deal effectively with claimants, employers, and/or insurers, and provided the knowledge and abilities described below.

Knowledge of Workers' compensation laws, regulations, procedures, benefits, rights and obligations of parties involved; workers' compensation claims management practices; insurance industry practices; applicable privacy protection laws, rules, and regulations; pertinent sources of information on medical terminology, treatment and care of industrial injuries; research methods and techniques; problem solving methods and evaluative techniques; interviewing methods and techniques; basic arithmetic (addition, subtraction, multiplication, division); and report writing.

Ability to Interpret, apply and explain workers' compensation laws, rules, policies, procedures, and benefits; investigate, examine and monitor workers' compensation claims; identify problems and develop alternative solutions; establish and maintain effective working relationships; communicate effectively orally and in writing; prepare clear and concise correspondence and reports; and perform basic arithmetic calculations (addition, subtraction, multiplication, division).

NON-QUALIFYING EXPERIENCE:

Any clerical work experience, although it may be in the field of workers’ compensation, is not qualifying.

QUALITY OF EXPERIENCE

Possession of the required number of years of experience will not in itself be accepted as proof of qualification for a position. The applicant’s overall experience must have been of such scope and level of responsibility as to conclusively demonstrate that he/she has the ability to perform the duties of the position for which he/she is being considered.

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The State of Hawai'i complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If you require reasonable accommodations in completing an application, any pre-employment testing, or otherwise participating in the selection process, please call 808-586-9084 for assistance.

PUBLIC SERVICE LOAN FORGIVENESS (PSLF) PROGRAM

The PSLF Program is a federal program that is intended to encourage individuals to work in public service by forgiving the balance of their federal student loans. To qualify, the individual must have made 120 qualifying payments while employed by a qualifying employer. For more information, please click: https://studentaid.gov/manage-loans/forgiveness-cancellation

ELECTRONIC NOTIFICATION TO APPLICANTS

The Department of Labor and Industrial Relations (DLIR) will use electronic mail (email) to notify applicants of important information relating to the status and processing of their applications as part of our ongoing efforts to increase operational efficiency, promote the conservation of green resources, and minimize delays and costs.

Please ensure that the email address and contact information you provide is current, secure, and readily accessible to you. We will not be responsible in any way if you do not receive our emails or fail to check your email-box in a timely manner. In addition, please be aware that you may no longer receive notification about applications submitted if you choose to disable the Job Application Emails feature in your Account Settings.

TESTING INFORMATION

The examination for this recruitment will be conducted on an unassembled basis where the examination score is based on an evaluation and rating of your education and experience. It is therefore important that your employment application provide a clear and detailed description of the duties and responsibilities of each position you held.

In-person interviews and/or further testing in Hawaii may be required at the discretion of the hiring agency. If in-person interviews and/or further testing is a requirement, applicants who meet the minimum qualification requirements and are referred to the vacancy must be available to participate in person and at their own expense in this required phase of the selection process.

Applicants are encouraged to submit their applications as soon as possible. In addition to employment availability and score, the referral of qualified applicants may be based upon other factors including date of receipt of application.