Uninsured Employer Fund(UEF) Specialist (Administrative Officer I)

Introduction

\r\n\r\nReimagine a career in public service. At WCC, we are collaborative and team oriented, innovative in our approach, and passionate about our work. We thrive on initiative, creativity and challenges to the status quo. Our employees are valued and empowered. We are proud of our achievements and consider excellence and continuous journey...not a destination end point. If you've got the right stuff and a passion for your work, com journey with us.\r\n\r\n\r\nOUR MISSION\r\nThe Maryland Workers' Compensation Commission seeks to secure the equitable and timely administration of the provisions of the Maryland Workers' Compensation law on behalf of its customer, the injured workers, and their employers, by providing an efficient forum for the resolution of individual claims.\r\n\r\n\r\nOUR VISION\r\nThe Workers' Compensation Commission envisions a state wherein injured workers and employers are empowered to create an equitable partnership to facilitate prompt and fair resolution of workers' compensation matters.\r\n\r\n\r\nABOUT US\r\nTogether we profoundly touch the lives of so many people and have enormous responsibility to the community by fulfilling our mission of securing equitable and timely administration of the law. The Commission continues to provide services to our constituent partners at a level rarely met throughout the United States. The professionalism, work ethic, and technological acumen manifest in our operations allows us to smoothly and effectively manage the challenges which invariably arise. Every division within the agency plays a vital role in keeping us in the forefront nationally.\r\n

GRADE

13\r\n\r\n

LOCATION OF POSITION

10 East Baltimore St., Baltimore, MD 21202\r\n

Main Purpose of Job

The main purpose of this position is to oversee the review, investigation, and processing of workers’ compensation claims involving potentially uninsured employers. Serving as a subject matter expert within the Claims Division, the role ensures that claims are accurately evaluated for Uninsured Employers Fund (UEF) eligibility and handled in compliance with applicable laws and regulations in accordance with COMAR 14.09.05. By conducting detailed coverage research and collaborating with internal divisions, this position supports the agency’s mission to protect injured workers and uphold employer compliance, particularly in response to increased expanded Employer Compliance initiatives.\r\n

POSITION DUTIES

\r\nUEF Claim Determination & Investigation�\r\n\r\n\r\n Independently review and analyze claims to determine eligibility for\r\n designation under the Uninsured Employers Fund (UEF).�\r\n Conduct detailed investigations into employer insurance coverage\r\n status at the time of injury.�\r\n Compile and document findings and communicate determinations to the\r\n Insurance Compliance Division as well as other constituents.�\r\n Serve as the primary point of review for claims coded or flagged as\r\n potential UEF cases.�\r\n Independent judgment and analysis in applying and interpreting\r\n complex administrative plans or policies.�\r\n Confers with other administrative officials, program heads, staff\r\n specialists or others in order to exchange information pertaining to UEF claims\r\n or interpret policies or offer recommendations.\r\n\r\n\r\n\r\n\r\nClaims Processing & Case Management�\r\n\r\n\r\n Manage Workers’ Compensation UEF claims from initial intake through\r\n final resolution.\r\n �Review, analyze, and process claims documentation for completeness,\r\n accuracy, and compliance.�\r\n �Ensure UEF claims contain the required claimant’s questionnaire in\r\n accordance with COMAR 14.09.02.�\r\n Ensure timely and equitable routing of documents\r\n and actions through the CompHub system.�\r\n\r\n\r\n\r\n\r\nRegulatory Compliance\r\n\r\n\r\n �Apply working knowledge of COMAR14.09.05.01 regulations and Workers’\r\n Compensation statutes to claims handling activities.\r\n �Ensure all actions and decisions adhere to legal and procedural\r\n requirements.�\r\n Identify and escalate compliance issues as\r\n appropriate to the Insurance Compliance Division, NCCI, UEF, and/or Director of\r\n Claims\r\n Monitor claims where attorneys for employer/insurers\r\n have not entered their appearance in a claim in accordance with COMAR\r\n 14.09.02.08.\r\n Receives and codes workers' compensation claims\r\n and related case documents;\r\n Reviews claims for completeness, accuracy and\r\n compliance with agency regulations and procedures;\r\n Independently monitor and process workers’\r\n compensation claims from inception through resolution.\r\n Review claims to ensure compliance with COMAR\r\n 14.09.02.08 regarding attorney entries of appearance for employers and\r\n insurers\r\n Contact insurers, employers, and legal\r\n representatives concerning missing or incomplete attorney appearances.\r\n Provide\r\n technical guidance and expertise related to workers’ compensation claim\r\n procedures and regulatory compliance requirements.�\r\n Initiate\r\n corrective actions for non-compliance, including preparation and issuance of\r\n warning letters.\r\n Maintain\r\n accurate claim records, correspondence, and documentation within applicable\r\n systems.\r\n Coordinate\r\n with internal staff and external stakeholders to support timely claim\r\n administration and compliance enforcement.\r\n Determines whether claims may be compensated or\r\n deferred for a hearing or held pending the receipt of additional information;\r\n Contacts claimants, employers, insurers,\r\n attorneys and other members of the compensation community to obtain and clarify\r\n pertinent information;\r\n Rescinds orders, withdraws claims and amends\r\n awards as appropriate;\r\n Explains workers' compensation laws and\r\n procedures to claimants, employers, insurers, members of the legal and medical\r\n professions, and other interested parties;\r\n\r\n\r\n\r\n\r\nOther Duties as assigned\r\n\r\n\r\n

MINIMUM QUALIFICATIONS

Education:�� Graduation from an accredited high school or possession of a high school equivalency certificate. \r\nExperience:�One year of administrative staff or professional work. \r\nNotes:\r\n1. Candidates may substitute 30�college credit hours from an accredited college or university for�the required experience.\r\n2. Candidates may substitute U.S. Armed Forces military service experience as a commissioned officer involving staff work that included�regular use of independent judgment and analysis in applying and interpreting complex administrative plans, policies, rules or regulations or analysis of operational programs or procedures with recommendations for improvement on a year-for-year basis for the required�experience. \r\n

DESIRED OR PREFERRED QUALIFICATIONS

Three (3) or more years of experience investigating and adjudicating workers' compensation claims, including determining compensability, gathering, and evaluating evidence, and documenting claim findings.\r\n�\r\nWorking knowledge of Maryland workers' compensation laws, regulations, and procedures, including familiarity with COMAR 14.09.05.01 and related provisions governing uninsured employers.�\r\n�\r\nDemonstrated ability to exercise independent judgment in interpreting and applying complex statutes, regulations, administrative plans, policies, and procedures.\r\n�\r\nStrong analytical and investigative skills, with the ability to evaluate conflicting information, identify relevant facts, and make well-supported recommendations or determinations.\r\n

LIMITATIONS ON SELECTION

This recruitment is limited to current Maryland Workers' Compensation Commission employees.\r\n

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator’s license valid in the State of Maryland.\r\n\r\n

SELECTION PROCESS

Please make sure that you provide sufficient information on your application to show that you meet the qualifications for this recruitment. All information concerning your qualifications must be submitted by the closing date.�We will not consider information submitted after this date.�Successful candidates will be ranked as Best Qualified, Better Qualified, or Qualified and placed on the�eligible (employment) list for at least one year.\r\n

BENEFITS

STATE OF MARYLAND BENEFITS\r\n

FURTHER INSTRUCTIONS

\r\n\r\n \r\n \r\n\r\n\r\nIf you\r\nare unable to apply online, or encounter difficulty attaching required or\r\noptional documentation, you may submit\r\nvia mail or deliver in person. Please be sure to include your name,\r\nidentification number (Easy ID#) and job announcement number (26-002711-0029) on any documentation to ensure timely processing. Submission of a resume is strongly\r\nencouraged.\r\n\r\n\r\n\r\nPLEASE DO NOT FAX OR EMAIL UNSOLICITED DOCUMENTATION�\r\n\r\n\r\n�Completed applications, required documentation, and any\r\nrequired addendums may be mailed to:�\r\nWorkers' Compensation Commission\r\nAttn: Personnel\r\nDivision�\r\n10 E. Baltimore Street, 7th Floor�\r\nBaltimore, MD 21202\r\n\r\n\r\n\r\n�The MD State Application Form can be found online.�\r\n\r\n\r\n�For more information, please email wccpers@wcc.state.md.us. TTY Users: call via Maryland Relay\r\nWorkers' Compensation Commission is an equal\r\nopportunity employer. It is the policy of WCC that all persons have equal\r\nopportunity and access to employment opportunities, services, and facilities\r\nwithout regard to race, religion, color, sex, age, national origin or ancestry, marital status, parental status, sexual orientation, disability or veteran status\r\n\r\n\r\n