Claims Specialist (136322)
- Employer
- University of Illinois at Urbana-Champaign
- Location
- Champaign, IL
View more
- Institution Type
- Four-Year Institution
Job Details
Claims Specialist
Claims Management
University of Illinois System - Urbana
The University of Illinois is an Equal Opportunity, Affirmative Action employer that recruits and hires qualified candidates without regard to race, color, religion, sex, sexual orientation, gender identity, age, national origin, disability or veteran status. For more information, visit http://go.illinois.edu/EEO.
The University System Office seeks a Claims Specialist to, under direction of the Associate Director, manage medical-only workers' compensation claims for the System, and non-litigated general liability claims for UIS and UIUC. In addition, this position will act as the auto liability coordinator for UIS and UIUC for claims that arise from the use of state vehicles. This position is also responsible for meeting mandated reporting requirements in regards to Medicare and Medicaid Services (MSP Section 111).
Duties and Responsibilities
- Manage non-litigated "medical only" Workers' Compensation Claims up to the 20K level. Responsible for reviewing and analyzing medical reports, billing, providing monthly reports and counseling of claimants regarding Worker's Compensation benefits. Act as the liaison with claimants, health care providers, physicians, hospitals, insurance companies, government agencies, including but not limited to Medicare, OSHA, and the Illinois Department of Labor and related interested parties regarding payment and closure of claims.
- Be the primary point of contact for general liability claims of bodily injury, property damage, and veterinarian non-litigated liability claims for the Urbana and Springfield campuses, including UI Extension facilities. Investigate potential claims for compensability, provide payment or issue letters of denial, whichever is applicable.
- Serve as the primary point of contact and University resource for UIS and UIUC auto liability claims, including preparing and forwarding claim reports to the State of Illinois office of Central Management Services for adjudication, and responding to CMS inquiries within 24 hours of receipt, and responding to campus unit inquiries as needed.
- Ensure appropriate and thorough documentation of the electronic database, including writing comprehensive file notes, scanning and attaching correspondence of all types, and explaining when reserve changes are made. Maintain and regularly update claim management reports to ensure claims are managed in the most efficient and effective manner possible and reports are provided to management on a timely basis.
- Correspond with insurance providers, government agencies and persons' utilizing their Workers' Compensation benefits as required to identify, collect and analyze the information to properly complete the simple claim forms for payment to various medical providers.
- Advise and assist Medical Insurance staff and related clerical support employees concerning the proper action to be taken to complete, bill, collect, or adjudicate medical claims. Verifies ICD-9-CM or ICD-10-CM coding and HCPCS procedure coding to determine accuracy of claims. Oversee repricing of medical-only invoices according to Illinois Workers Compensation Fee Schedule.
- Communicate with University Counsel staff on UIUC campus to clarify and update information related to non-litigated general liability claims, and workers' compensation claims as needed. Maintain the Legal Files Claims database, and prepare reports for review by the Associate Director.
- Prepare financial documentation to support settlement recommendations and follow established protocols to request general liability claims settlement authority from Risk Management and UI Legal Counsel prior to engaging in settlement discussions.
- Write subrogation letters to responsible parties for general liability and auto claims to ensure maximum financial recovery when these other entities are responsible for damaging state (UI) property.
- File paper correspondence as needed to ensure claim files are up to date.
- Perform other related duties as assigned by Associate Director of the Office of Claims Management and Workers' Compensation.
Education and Experience
Required:
- Bachelor's degree in business administration, claims or risk management, or related field.
- Two years property or casualty claims handling or adjusting experience
Preferred:
- Medical claims adjusting experience preferred.
Knowledge, Skills and Abilities
- Knowledge of insurance principles and claims handling processes.
- Detail-oriented and ability to prioritize assignments.
- Ability to work independently and exercise good judgment/decision making and discretion in the performance of all work assignments, and with handling documents containing confidential and sensitive information.
- Ability to work effectively with staff and the public, including excellent verbal and written communications skills to interact with departmental officials/staff and external groups seeking assistance from the Office of Claims Management and Workers' Compensation.
- Strong interpersonal skills to develop and maintain effective work relationships and provide good customer service.
- Proficiency using the Microsoft Office suite of products.
- Proficiency with office equipment including photocopiers, printers, digital scanners, and calculators.
SALARY AND APPOINTMENT INFORMATION
This is a full-time Civil Service Program Assistant position appointed on a 12 month service basis. The expected start date is as soon as possible after October 12, 2020. Salary is commensurate with experience.
TO APPLY:
Applications must be received by October 12, 2020. Apply for this position using the “Apply for Position” button below. If you have not applied before, you must create your candidate profile at http://jobs.illinois.edu. If you already have a profile, you will be redirected to that existing profile via email notification. To complete the application process:
Step 1) Submit the Staff Vacancy Application.
Step 2) Submit the Voluntary Self-Identification of Disability forms.
Step 3) Upload the following documents:
In order to be considered as a transfer candidate, you must apply for this position by going to http://jobs.illinois.edu. Applications not submitted through this website will not be considered. For further information about this specific position, contact Melissa McMullen at msstein@uillinois.edu For questions about the application process, please contact 217-333-2137.
The University of Illinois conducts criminal background checks on all job candidates upon acceptance of a contingent offer.
As a qualifying federal contractor, the University of Illinois System uses E-Verify to verify employment eligibility.
The University of Illinois System requires candidates selected for hire to disclose any documented finding of sexual misconduct or sexual harassment and to authorize inquiries to current and former employers regarding findings of sexual misconduct or sexual harassment. For more information, visit Policy on Consideration of Sexual Misconduct in Prior Employment
College Name or Administrative Unit:System Office Category:3-Administrative Support Title:Claims Specialist (136322) Open Date:09/24/2020 Close Date:10/12/2020 Organization Name:UIUC Claims Management
Organization
Since its founding in 1867, the University of Illinois at Urbana-Champaign has earned a reputation as a world-class leader in research, teaching, and public engagement.
Faculty
A talented and highly respected faculty is the University's most significant resource. Many are recognized for exceptional scholarship with memberships in such organizations as the American Academy of Arts and Sciences, the National Academy of Sciences, and the National Academy of Engineering.
Our faculty have been awarded Nobel Prizes, Pulitzer Prizes, and the Fields Medal in Mathematics.The success of our faculty is matched by that of our alumni: 11 are Nobel laureates and another 18 have won Pulitzer Prizes.
Academic Resources
Academic resources on campus are among the finest in the world. The University Library is one of the largest public university collections in the world with 11 million volumes in its 37 unit libraries. Annually, 53,000,000 people visit its online catalog. Students have access to thousands of computer terminals in classrooms, residence halls, and campus libraries for use in classroom instruction, study, and research.
Research
Students and scholars find the University an ideal place to conduct research. The Beckman Institute for Advanced Science and Technology is a model for interdisciplinary research, where eighteen research groups from sixteen University departments work within and across three broadly defined themes: biological intelligence, human-computer intelligent interaction, and molecular and electronic nanostructures. The University is also home to the National Center for Supercomputing Applications (NCSA).
Undergraduate Education
The University has a fundamental commitment to undergraduate education. Nearly 28,000 undergraduate students are enrolled in nine undergraduate divisions, which together offer some 4,000 courses in more than 150 fields of study.
Undergraduate admission is highly selective. In the 2001 freshman class, students in the middle 50% had ACT scores between 25 and 30 and ranked between the 83rd and 96th percentiles of their high school graduating classes.
The University enrolls over 9,000 graduate and professional students in more than 100 disciplines. It is among the top five universities in number of earned doctorates awarded annually in the United States.
Also integral to the University's mission is a commitment to public engagement. Each year about 65,000 Illinois residents participate in scores of conferences, institutes, courses, and workshops presented statewide. Research and class projects take students and professors off campus to share expertise and technical support with Illinois farmers, manufacturing firms, and businesses. In a typical year, student volunteers log more than 60,000 volunteer hours.
The Arts
A major center for the arts, the campus attracts dozens of nationally and internationally renowned artists each year to its widely acclaimed Krannert Center for the Performing Arts. The University also supports two major museums: the Krannert Art Museum and Kinkead Pavilion; and the Spurlock Museum, a museum of world history and culture.
Other major facilities include the multipurpose Assembly Hall (16,500 seats); Memorial Stadium (70,000 seats), site of Big Ten Conference football games; and the Intramural-Physical Education Building, one of the largest recreational facilities of its kind on a university campus.
Inclusive Illinois, one campus, many voices
Inclusive Illinois is the University’s commitment to cultivating a community at Illinois where everyone is welcomed, celebrated, and respected. Illinois is about how we value difference to make a difference. http://www.inclusiveillinois.illinois.edu/
As evidence of the University’s commitment to enhance the working, living, and learning environment for faculty, staff, and students, the University will encourage a standard of conduct and behavior that is consistent with the values of inclusivity. In an environment of inclusivity, there is no place for acts of hatred, intolerance, insensitivity, bigotry, threats of violence, harassment or discrimination.
Inclusive Illinois, one campus, many voices
Inclusive Illinois is the University’s commitment to cultivating a community at Illinois where everyone is welcomed, celebrated, and respected. Through education, engagement, and excellence, each voice creates the Inclusive Illinois Experience.
How can we appreciate difference to make a difference?
Illinois is the place where we embrace difference. We embrace it because we value it. We value it because we know that we have so much to learn from each other in our living, learning, and working environment.
Illinois is the place where we recognize the power of possibility and where great potential is realized. Inclusive Illinois is the vision of that place: a vision made real by leadership and commitment.
Illinois is the place where consensus is forged by discourse and where everyone’s contributions are recognized: significant contributions that elevate us because they are informed and enhanced by race, ethnicity, gender, sexual orientation and gender identity, age, physical ability, religion, class, and national origin. We are enriched by these perspectives, and we are united by the very discourse that brings these views together.
It is a process. It is transformative. And we celebrate the remarkable changes we set in motion here … taking an important step … crossing boundaries … starting with our own.
It all starts with each of us: with our willingness to embark on the journey in the search for answers, and with our openness and acceptance of the answers we find. Illinois is the place where it all comes together.
Learn more about how Inclusive Illinois promotes diversity here.
Commitment to Equal Opportunity
The commitment of the University to the most fundamental principles of academic freedom, equality of opportunity, and human dignity requires that decisions involving students and employees be based on individual merit and be free from invidious discrimination in all its forms, whether or not specifically prohibited by law. Among the forms of invidious discrimination prohibited by the University policy but not law is discrimination, including harassment, on the basis of sexual orientation. Complaints of invidious discrimination in violation of University policy are to be resolved within existing University procedures. The policy of the University of Illinois is to comply with all federal and state nondiscrimination, equal opportunity, and affirmative action laws, orders, and regulations. The University will not engage in discrimination or harassment against any person because of race, color, religion, sex, national origin, ancestry, age, marital status, disability, unfavorable discharge from the military, or status as a disabled veteran or a veteran of the Vietnam era. This nondiscrimination policy applies to admissions, employment, and access to and treatment in University programs and activities
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