RESEARCH AND TRAINING SPECIALIST - 43003011

Requisition No: 873580 

Agency: Financial Services

Working Title: RESEARCH AND TRAINING SPECIALIST - 43003011

 Pay Plan: Career Service

Position Number: 43003011 

Salary:  $45,060.11 - $95,283.82 

Posting Closing Date: 04/15/2026 

Total Compensation Estimator Tool

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

CLASS TITLE: RESEARCH & TRAINING SPECIALIST

DIVISION: WORKERS’ COMPENSATION

BUREAU: MONITORING AND AUDIT

CITY: TALLAHASSEE

COUNTY: LEON

SPECIAL NOTES:

Four (4) years of experience in a relevant field (risk management, insurance, claims handling, medical billing and reporting, financial accounting, or auditing) is required.  A post-secondary degree from an accredited college or university may substitute for the required work experience.

Additional requirements:

• Three (3) years or more of regulatory experience.
• Three (3) years or more of experience working with Microsoft Office (Outlook, Word, Excel, and PowerPoint)
• Three (3) years or more of data analysis.

Preferences:

• Two (2) years or more of leadership experience.
• One (1) year or more experience with International Association of Industrial Accident Boards and Commissions (IAIABC) Claims EDI Release 3.
• Two (2) years or more of experience interpreting rules, regulations, policies, and procedures.
• Two (2) years or more of experience in workers’ compensation medical and claims data collection.
• Two (2) years or more of experience creating training documents and presenting information.
• Two (2) years or more of experience utilizing investigative techniques and practices.
• Two (2) years or more of Electronic Data Interchange (EDI) knowledge and experience.

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

Knowledge of data collection methods; problem-solving techniques; data analysis; and management principles.  Ability to apply investigative principles and techniques; review, analyze and evaluate data; collect, analyze, and interpret data; organize data into logical format for presentation in reports and other written materials.  Ability to understand and apply applicable rules, regulation, policies, and procedures relating to management analysis practices; understand and apply workers’ compensation statutes, rules, and procedures; examine and evaluate data related to workers’ compensation programs.  Ability to conduct fact finding investigations; conduct interviews; and prepare and maintain statistical data and reports.  Ability to handle conflict and disputes in a professional and courteous manner. Demonstrated knowledge, understanding, and application of Chapter 440, FL Statutes, and related rules. Skill in using personal computer and Microsoft programs. Ability to communicate verbally and in writing; utilize deductive reasoning; establish and maintain effective working relationships with others.  Ability to meet performance expectations.

OTHER KSAs (Incumbent may learn on job)

• Ability to apply/interpret W.C.  law, rules, and other procedures in developing new and improved data management and collection activities.  

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

Regarding anticipated starting salary, the Division of Workers’ Compensation typically hires at or near the minimum, unless an incumbent possesses direct and relevant experience in the job that they are a candidate for.  The Division is prepared to negotiate the salary depending upon the candidates’ direct and relevant experience.

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.

BRIEF DESCRIPTION OF DUTIES:

This is professional work providing management consulting services for the Division of Workers’ Compensation, Bureau of Monitoring & Audit to improve management capabilities and operational procedures related to the design, management, documentation and evaluation of processes involved in the collection, quality control, storage and reporting of medical, claims and policy data collected by the Division.

The Research & Training Specialist will carry out all required processes and communications with medical submitters, Trading Partners, insurers and/or claim administrators to ensure electronic reporting compliance in accordance with Chapter 440 and Administrative Codes. *Conducts investigations to acquire facts needed to resolve electronic medical bill, policy and claims rejections regarding filing requirements.  Communicates rejection information via email (or telephone when needed) outlining required corrections. Responsible for reviewing insurers, Trading Partners, and medical submitters performance. *Investigates complaints regarding violations of the law and Division Rules as assigned by the Operations & Management Consultant Manager.  Monitors carrier practices by identifying and documenting violation trends and provides recommendations to the Operations & Management Consultant Manager. Assists Operations & Management Consultant Manager and Regulatory Analyst Supervisors with identifying the need for internal program modifications. Conducts testing for enhancements made to ensure compliance with program design.    

Provides technical assistance and serves as a liaison to medical submitters, Trading Partners, insurers and claim administrators with questions relating to the Workers’ Compensation law and claims handling practices. Trains medical submitters, Trading Partners, insurers and claim administrators on program filing specifications. Trains team members on WC processes and procedures, statute and rules, EDI and WC history. Responds to customer training requests for extensive knowledge of workers’ compensation. Investigates cases to determine questionable claims handling practices by medical submitters, Trading Partners, and insurers in accordance with Florida Statutes. Assists Operations & Management Consultant Manager and Regulatory Analyst Supervisor with monitoring performance of servers involved in daily processing of electronic submissions in order to assure consistent functionality and adequate capacity in moving electronically submitted claims continuously through the system, without delays or backlogs.

Creates and maintains documentation on various EDI transaction filing requirements for the State of Florida, including electronic filing manuals, data element requirements, edit matrixes, event criteria, program edits, implementation guides, etc. Assist the Operations & Management Consultant Manager and Regulatory Analyst Supervisor with conducting research to analyze program user needs, program hindrances and other issues impacting operating practices. In conjunction with the Operations & Management Consultant Manager and Regulatory Analyst Supervisor, participates in team projects and training aimed at improving data collection techniques and practices. Reports critical problems to Operations & Management Consultant Manager and Regulatory Analyst Supervisor when delays in resolution interfere with daily production. Assists Operations & Management Consultant Manager and Regulatory Analyst Supervisor with issues stemming from national EDI development committee meetings.  

Performs work independently, subject to review by the Operations & Management Consultant Manager. Follows Department Internal Controls Policy and Bureau procedures/instructions to ensure confidential information accessed is secured and not disclosed outside of position duties. 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.

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.  Certain service members may be eligible to receive waivers for postsecondary educational requirements.  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.