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INSURANCE SPECIALIST III - 43001688

Date: Nov 19, 2020

Location: TALLAHASSEE, FL, US, 32312

The State Personnel System is an E-Verify employer. For more information click on our E-Verify website.

Requisition No: 265262 

Agency: Financial Services

Working Title: INSURANCE SPECIALIST III - 43001688

Position Number: 43001688 

Salary:  The base annual salary is $32,696.88. 

Posting Closing Date: 12/03/2020 

*****OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY*****

DIVISION: WORKERS’ COMPENSATION

BUREAU: MONITORING AND AUDIT

CITY: TALLAHASSEE

COUNTY: LEON

SPECIAL NOTES:

A bachelor's degree or higher from an accredited college or university is required. Equivalent work experience in a relevant field (i.e. regulatory enforcement, claims and medical reporting, auditing, data analysis, penalty assessment review or investigating) may substitute on a year-for-year basis for the required education.

Preference shall be given to applicants with the following experience:

  • Two (2) or more years' of experience with Microsoft Work and Excel.
  • One (1) year of experience in Medical billing, risk management, insurance, claims handling, financial accounting, or auditing.
  • One (1) year of Regulatory experience.
  • One (1) year of experience in Electronic Data Interchange.
  • One (1) year of experience in workers’ compensation claims.

The base annual salary for this position is $32,696.88.

This position requires a security background check, including fingerprint as a condition of employment.

Employees of the Department of Financial Services are paid on a monthly pay cycle.

Responses to qualifying questions must be clearly supported by the state application and any omission, falsification or misrepresentation in the answering of the qualifying questions will be cause for immediate elimination from the selection process.

Minimum Qualifications for this position include the following REQUIRED ENTRY LEVEL KNOWLEDGE, SKILLS AND ABILITIES:

Knowledge of the principles and techniques of effective verbal and written communication.

Ability to communicate effectively

Ability to establish and maintain effective working relationships with others.

Ability to plan, organize and coordinate work activities.

Working knowledge of computer software (including Microsoft Office).

Knowledge of methods of compiling, organizing and analyzing data. 

Ability to maintain a high degree of accuracy and close attention to detail.

Ability to understand and apply applicable rules, regulations, policies and procedures.

Ability to handle telephone calls in a prompt, courteous and effective manner.

Ability to deal with the public in a tactful and courteous manner.

Ability to perform mathematical calculations.

OTHER KSAs (Incumbent may learn on job):

Basic knowledge of Florida’s workers’ compensation system.  Ability to investigate insurance claims; conduct fact finding investigations; prepare and maintain reports.  

BRIEF DESCRIPTION OF DUTIES:

This is work investigating and monitoring the business practices of insurance carriers, employers and servicing agents to ensure compliance with Workers’ Compensation law and procedures, specifically, sections 440.13, 440.15, 440.185, 440.20, and 440.021, Florida Statutes.

*Conducts investigations to acquire facts needed to issue penalty assessments against employers for violations of requirements for making timely benefit payments to injured workers and violations of document filing requirements.

*Conducts investigations and monitors carrier/TPA late indemnity payments and late filings with the Division to acquire facts needed to issue penalty assessments, documents penalty claim reviews, and requests various forms required by law for claim clarification and/or correction.

*Communicate by telephone or by certified demand letter for resolution when the penalized party has not paid or protested the assessment within the 20 days provided for in section 440.021, Florida Statutes. 

*Credit payments to the proper case and request Department refunds when the assessment is incorrectly paid or the claimant’s portion of the assessment is sent to the Department.

*Contacts by telephone employees, employers, insurance carriers/TPA’s, other Division of Workers’ Compensation Bureaus, attorneys, and other sources for information regarding employee/employer relationships, employer and carrier liability, claims process, etc., to determine validity of evidence to issue an action to reduce or revoke a penalty or deny a claim protest.

*Provides interpretation of the Workers’ Compensation Law, rules, and procedures regarding penalty assessments and advises employers, carriers/TPA’s of their rights and responsibilities under the Law in effect on the date of an employee’s accident.

*Prepares and maintains a permanent record of all actions taken and decisions issued for inclusion in any hearings before Judges of Compensation Claims, county court judges, and statistical purposes.  Assists legal office in preparing cases for hearings by preparing detailed reports of progress and investigation results, and attends hearings, providing testimony when necessary.

*Performs investigations of complaints regarding violations of the Workers’ Compensation Law and Division rules as assigned by the Insurance Administrator and assignments referred to the Penalty Section from other governmental agencies.  Investigates and monitors Workers’ Compensation carrier practices, identifying and documenting patterns and trends of violation and recommends to the Insurance Administrator action necessary to bring such practices into compliance.

*Performs other related duties as required.

If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida. Your current retirement benefits may be canceled, suspended or deemed ineligible depending upon the date of your retirement.

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

VETERANS’ PREFERENCE.  Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply.  Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.  Veterans’ Preference documentation requirements are available by clicking here.  All documentation is due by the close of the vacancy announcement. 


Nearest Major Market: Tallahassee