SERVICE COUNSELOR 3 - SENIOR CLAIMS EXAMINER

State of Tennessee
US - Tennessee - Nashville
November 11, 2024

Executive Service

Service Counselor 3 - Senior Claims Examiner Department of TreasuryCriminal Injuries Compensation DivisionNashville, TNClosing Date:
11/18/2024

Who we are and what we do:

The Tennessee Department of Treasury impacts the lives of Tennesseans every day.
Treasury is responsible for many of the financial operations of state government, including managing more than $100 billion in assets through its various investment programs.
We administer and invest the State's Retirement Program, RetireReadyTN, which combines the state pension plan, Tennessee Consolidated Retirement System, and the State's Defined Contribution plans.
Treasury serves all Tennesseans by helping to educate and empower them to make smart financial choices, and by providing public-serving programs in the areas of college savings, financial literacy, unclaimed property, risk management, criminal injuries compensation, and more.

Job Overview:

The Claims Examiner 3 position supports the various programs of the division with focus on tasks associated with claims filed for the Criminal Injury Compensation, Sexual Assault Forensic Exam, and Electronic Monitoring Indigency Fund Programs, as well as other operational, managerial, and training tasks as needed This position is within the Division of Claims and Risk Management (DCRM), Tennessee Department of Treasury.
The division manages funds and related activities including state employee workers' compensation (WC), liability claims filed against the State, Criminal Injuries Compensation (CIC), Sexual Assault Forensic Examination (SAFE) reimbursement, Electronic Monitoring Indigency Fund (EMIF) reimbursement, and various risk management and insurance coverage activities on behalf of the State and in coordination with its agencies.

The individual in this position will perform tasks to review and decide whether reimbursement decision by another team member is appropriate on claims filed by victims and their family members, as well as requests filed by service providers for these programs.
This position both approves claims recommendations and reviews claims of a higher level of difficulty or needing additional support.
At the present time, this position is primarily remote, with occasional required in-person meetings.
It is anticipated that the department will regularly utilize its downtown Nashville office on a hybrid schedule in the future.
Job location is subject to change at the discretion of the Department.
The successful candidate should live in Tennessee and provide sufficient internet connection.

Key Responsibilities:

Perform of review of claims decisions by other team members and approve or reject their decisions
Work with victims, claimants, family members, providers and others to explain the requirements for reimbursement, the process for reimbursement, and facilitates any part of that process that needs to be addressed on any claim filed.
Some communications occur before a claim is filed.
Provide exceptional customer services in a sensitive, professional and meaningful way to various internal and external customers both on the phone and it written correspondence.
Explain and follows statutory, procedural and other requirements as needed to fulfill responsibilities which vary depending on the claim.
Review materials carefully to ensure that the appropriate decision is made relative to the eligibility requirements and that sufficient supporting documentation has been submitted to support any reimbursement.
Make recommendations regarding eligibility and reimbursement, if applicable, for a supervisor to review.
Monitor responsibilities including, but not limited to, calls, correspondence, and work queues, etc.

Minimum Qualifications:

Graduation from a four-year college or university with a bachelor's degree and 3+ years' experience in claims handling or a social work-related field.
Ability to communicate professionally and effectively with the public, state agencies, universities, and co-workers.
At the discretion of the department experience processing claims described above for a contractor of TN Treasury, may be substituted for the educational requirement.
TN Treasury reserves the right to assess the appropriateness of such substitution on a case-by case basis.

Pursuant to the State of Tennessee's Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace.
It is the State's policy to provide an environment free of discrimination and harassment of an individual because of that person's race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran's status or any other category protected by state and/or federal civil rights laws.

Read the full job description and apply online on the recuiter's web-site

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