CLAIMS REVIEWER I

About the Agency

The Maryland Workers' Compensation Commission (WCC) is a collaborative, team-oriented agency that values initiative, creativity, and excellence. We are dedicated to securing the equitable and timely administration of Maryland’s Workers’ Compensation law for injured workers and employers. Our mission is to provide an efficient forum for resolving individual claims, and our vision is to empower both workers and employers to achieve prompt and fair resolutions. WCC is nationally recognized for its professionalism, work ethic, and technological innovation.

About the Role

This position is located at 10 East Baltimore Street, Baltimore, Maryland 21202. The Claims Reviewer I is responsible for reviewing, analyzing, investigating, and processing Workers’ Compensation claims and related documents in an equitable and timely manner, adhering to established rules and procedures. This role is eligible for a non-competitive promotion to Claims Reviewer II (Grade 10) after successfully completing a training program and performing the full range of duties under general supervision.

Responsibilities

• Review and process claim-related documents received in claims queues, including wage statements, appearances, and insurance corrections via CompHub.
• Process hearing-related documents such as emergency hearings, rehearings, postponements, motions, petitions, and withdrawals in accordance with established procedures.
• Analyze and process request for hearings (Issues) and award order corrections in CompHub.
• Review temporary total (TT) and compensation deferred (CD) orders for insured and non-insured claims and enter data into CompHub.
• Review and process C-40 responses, coding and processing Workers’ Compensation claims (regular, death, and medical).
• Generate and distribute claim copies to all essential parties through CompHub.
• Monitor undeliverable mail, notify parties, and maintain current business names and addresses.
• Handle incoming and outgoing telephone inquiries from employers, insurance companies, attorneys, and claimants to clarify or obtain additional information for processing documents.
• Ensure courtrooms are set up and ready for hearings.
• Assist with reception desk coverage, help the public obtain copies, process payments for copies, date-stamp and route incoming correspondence, process subpoenas, and ensure forms are accurate and up-to-date.

Requirements

• Education: High school diploma or equivalent.
• Experience: One year of clerical experience handling compensation claims or three years of general clerical experience.
• Selective Qualifications:
  • 6 months of experience working with claims from start to finish.
  • 1 year of data entry experience.

Candidates may substitute additional general clerical experience on a year-for-year basis for the required education. U.S. Armed Forces military service experience as a non-commissioned officer in Workers’ Compensation Claims Examining classifications or specialty codes in the Legal field may also substitute on a year-for-year basis for the required experience.

Preferred Qualifications

• 6 months of experience with Workers’ Compensation laws and regulations.
• 1 year of experience with workers’ compensation claims.
• 1 year of experience working with insurance companies or agencies.
• Intermediate skills in Microsoft Office (Word, Excel, Outlook, and PowerPoint).

Benefits

This position offers State of Maryland benefits.