WORKERS' COMPENSATION COMPLIANCE SUPERVISOR

AS615 $42,952 - $84,302
Creation Date: 06/29/1987
Change Date: 01/01/2025

FUNCTION OF WORK:
To supervise Workers' Compensation Compliance Analysts, Statisticians and lower level staff engaged in processing workers' compensation claim forms; to regulate and enforce the compliance of statutes governing the Office of Workers' Compensation Administration claim filing process by workers' compensation carriers or self-insured funds.

LEVEL OF WORK:
Supervisor

SUPERVISION RECEIVED:
Broad from the Workers' Compensation Compliance Manager or higher level administrator.

SUPERVISION EXERCISED:
Direct over Workers' Compensation Compliance Analysts, Statisticians and lower level staff.

JOB DISTINCTIONS:
Differs from Workers' Compensation Compliance Manager by the absence of responsibility for managing multiple units within the Records Management Section.

Differs from Workers' Compensation Compliance Analyst 2 by the presence of responsibility for direct supervision of Workers' Compensation Compliance Analysts, Statisticians and lower level staff.

CORE COMPETENCIES:
CORE COMPETENCIES HAVE NOT BEEN IDENTIFIED BY STATE CIVIL SERVICE FOR THIS JOB TITLE. MORE INFORMATION ON THE SCS COMPETENCY MODEL CAN BE FOUND HERE.

EXAMPLES OF WORK:
EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.

Supervises staff in monitoring of compliance in OWCA policies and procedures, and orders corrective actions as required; manages, investigates and resolves compliance violation complaints; identifies policy and compliance issues, and proposes solutions.

Analyzes and recommends policies and procedures for compliance activities; develops recommendations for improving the Office of Workers' Compensation Administration's (OWCA) compliance processes; directs the preparation of special and recurring reports and analytical studies on complex filing issues.

Supervises the assessment of documented discrepancies in insurance company submitted claims; oversees reviewing calculation of workers' compensation benefit payments and verification function. Make adjustments to correct workers' compensation benefit payments.

Supervises and monitors the analysis of Workers' Compensation claim forms for making determinations of proper Standard Industrial classification code (SIC) and North American Industry Classification System code (NAICS).

Plans and monitors the mailing of the Employee/Employer Key Steps brochure, which gives statement of the rights, benefits and obligations of employees and employers.

Direct the reviewing and editing of reports to track those workers' compensation claim forms rejected by the database. Approves the updating of the database with corrected information, and approves electronic files on daily basis.

Writes and edits the Office of Workers' Compensation Administration (OWCA) Annual Report as required by statute.

Supervises, plans, and conducts technical studies which illustrate the functions, activities and transactions carried out by the OWCA.

Directs, supervises, and establishes procedures and techniques for the statewide collection, compilation, audit, evaluation, analysis, interpretation, and dissemination of complex, and technical statistical information on number, and frequency of work-related fatal and non-fatal occupational injury and illness claims.

Supervises auditing of documents for compliance with applicable rules, regulations and procedures; maintains the accuracy and confidentiality of statistical databases and develops procedures for quality control of databases.

QUALIFICATION REQUIREMENTS:
MINIMUM QUALIFICATIONS:
Six years of experience in worker's compensation claims or dispute resolution, injury investigation, insurance claims examining, or statistical analysis; OR

Six years of full-time experience in any field plus three years of experience in worker's compensation claims or dispute resolution, injury investigation, insurance claims examining, or statistical analysis; OR

A bachelor's degree plus three years of experience in worker's compensation claims or dispute resolution, injury investigation, insurance claims examining, or statistical analysis.

EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.