Our Ability Jobs

NY HELP Yes

Agency Insurance Fund, State

Title Claims Services Representative 1/Trainee 1/Trainee 2 (NY HELPS)

Occupational Category Other Professional Careers

Salary Grade NS

Bargaining Unit PS&T - Professional, Scientific, and Technical (PEF)

Salary Range From $49363 to $82656 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8:30 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Broome

Street Address 2001 Perimeter Rd. East

City Endicott

State NY

Zip Code 13760

Minimum Qualifications For Appointment to Claims Services Representative Trainee 1:•Reachable on current Civil Service eligible list for this title; OR•One year of permanent, competitive class service in a title eligible for transfer under Section 70.1 of the Civil Service Law. Eligible titles include, but are not limited to: Investigator 1, Assistant Insurance Fund Services Representative, Program Aide; OR•A bachelor's or higher degree (in any area of study).For Appointment to Claims Services Representative 1, SG-18:•Reachable on current Civil Service eligible list for this title; OR•One year of permanent, competitive class service in a title eligible for transfer under Section 70.1 of the Civil Service Law. Eligible titles include, but are not limited to: Administrative Specialist 1, Investigator 2 (Compensation Claims), Policyholder Services Representative 1, Underwriter 1, Underwriter 1 (Disability Benefits); OR•A bachelor’s or higher degree AND two years of professional experience; OR •A juris doctor, master’s or higher degree in a field related to the position being filled AND one year of professional experience. Candidates who are active on the most recent Professional Career Opportunities examination list are encouraged to apply. Please be advised that the New York State Insurance Fund does not offer sponsorship for employment visas to employees or potential employees. Candidates sponsored for employment by an organization should be aware of their sponsorship status and the relevant expiration date(s) of that sponsorship before applying to this position.

Duties Description Under the general supervision of a Claims Services Representative 2, oversees all aspects of workers compensation claims processing from inception to closing; initially determines the compensability of claims and files appropriate documentation with the Workers Compensation Board (WCB); calculates and adjusts reserves consistent with case analysis over the anticipated life of the claim; recommends cases for appeal to WCB; negotiates and/or makes recommendations regarding lump sum settlements; issues payments and requests for reimbursement where claims for supplemental benefits are involved; reviews awards to ensure the correct recipient and rate of compensation; schedules or waives medical examinations as necessary; analyzes medical bills to determine causality, levels of treatment, necessity for treatment, appropriateness of fees and procedure codes, and apportionment status; responds to requests for home modifications, home health care personnel, medication, and medical supplies and appliances; and reviews case activity and determines when a claim can be retired.Specific duties to be discussed at time of interview.

Additional Comments This position may be designated 55 b/c and is subject to verification of applicant eligibility.Telecommuting: All new hires to the NYSIF Claims Department are required to work in-office for a minimum of their first four weeks of employment. After four weeks, you may then apply for 1 day of telecommuting per week. From there, the amount of telecommuting days allowed will increase up to a maximum of 50% per pay period after 12 successful weeks in the position.This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).For the duration of the NY HELPS Program, this title maybe filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply. At this time, agencies may recruit and hire employees by making temporary appointments. In May 2024, if a temporary NY HELPS employee is satisfactorily performing in the position, the appointment will be changed from temporary pending Civil Service Commission Action to permanent non-competitive and the official probationary period will begin.At a future date (within one year of permanent appointment), it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified.The New York State Insurance Fund (NYSIF) was established in 1914 as part of the original enactment of the New York State Workers’ Compensation Law. NYSIF's mission is to guarantee the availability of workers’ compensation insurance at the lowest possible cost to New York employers and to provide timely, appropriate indemnity and medical payments to injured workers, while maintaining a solvent fund. Since inception, NYSIF has fulfilled the dual roles for which it was created: to compete with other carriers to ensure a fair marketplace and to be a guaranteed source of coverage for employers who cannot secure coverage elsewhere.NYSIF is the largest workers’ compensation carrier in New York State and among the top 10 largest workers’ compensation carriers in the nation, insuring approximately 139,000 policyholders, with more than $1.8 billion in annual earned premium and over $20 billion in assets. A self-supporting insurance carrier, NYSIF operates without taxpayer funding.In addition to workers’ compensation insurance, NYSIF provides disability benefits coverage for off-the-job injuries to more than 56,000 New York employers. In 2018, NYSIF added paid family leave as a component of its disability benefits product, providing New Yorkers with job-protected, paid time away from work to care for their families.NYSIF Commitment to Diversity, Equity, and InclusionThe New York State Insurance Fund (NYSIF) prioritizes and champions diversity, equity, and inclusion (DEI) throughout our agency. NYSIF provides equal opportunities to all employees and applicants for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability, veteran status, or any other protected category under federal, state, and local law. We believe that embracing our differences brings richness, new ideas and experiences to NYSIF, which energizes a creative and innovative work environment. We strive to foster a workplace where diverse individuals are able to participate fully in the decision-making process and have ample opportunity for advancement. We are committed to investing the necessary resources and attention to improving the engagement, retention, and promotion of the extraordinary talent we have. #NYSIF

Some positions may require additional credentials or a background check to verify your identity.

Name Eva-Rae Andrews

Telephone

Fax (518) 437-1618

Email Address hr@nysif.com

Address

Street PO BOX 66699

City Albany

State NY

Zip Code 12206

Notes on Applying Candidates should email resume and cover letter to hr@nysif.com. Please include the position title, Vacancy ID number, and your current Civil Service title on your cover letter.