Workers' Compensation Specialist

Summary

The mission of DFEC is to administer the Federal Employees' Compensation Act (FECA) (5 U.S.C. § 8101 et. seq.) by developing and adjudicating new claims for benefits, managing ongoing claims, authorizing and paying medical and compensation benefits to injured worker and survivors, and helping injured employees return to work when they are able to do so. Position is in the Bargaining Unit.

Duties

-Primary point of coordination, contact, oversight, and problem resolution for compensation payments and insurance benefits. -Provide expert technical advice, support, and recommendations to agency management officials, claims examiners, fiscal operations specialists, administrative staff and federal agency personnel on interpretation of policies, programs, regulations, and statutes concerning insurance benefits. -Serves as the Federal Employees Health Benefits (FEHB/Federal Employees Group Life Insurance (FEGLI)/Federal Employees Dental and Vision Insurance Program (FEDVIP) point of contact for the program's claimants, beneficiaries, insurance carriers and federal agencies. -Serves as a liaison for the Department of Labor's Solicitor's Office on all matters related to third party subrogation payments and surpluses. Assists claims staff with tracking surpluses and administering benefits while surplus is in place. -Pulls reports from Treasury and enters appropriate fiscal data in the compensation system. Posts cash receipts received in the National office to Fund Control Register. These monies come from a variety of different sources such as medical provider, third party recoveries, employing agencies, claimants and OPM. Analyzes reports from the Office of Personnel Management's FEHB Centralized Enrollment Clearinghouse System (CLER). Conducts reconciliation actions on all identified discrepancies -Analyzes operations and, as necessary, develops procedures and processes to help prevent internal fraud and abuse, and improve accountability and efficiency. -Resolves unusual, delicate, or time-sensitive situations, e.g., those involving congressional inquiry or coordination outside the agency. Resolves the most complex and sensitive insurance benefit case issues with unique situations normally not covered under operating norms or procedure -The incumbent may provide guidance and training to branch employees and claims staff on procedures related to FEHB/FEGLI/FEDVIP benefits and how they impact compensation payments. -Reviews policies, practices, written guidance and records to ascertain compliance with DOL and government-wide policy. Identifies areas for improvement and provides guidance and instruction to assist in making improvements. -Keeps accurate records and creates reports for tracking payments to groups specifically identified by the Branch Chief.

Qualifications

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Position titles alone cannot be used to determine if you are qualified. Please list dates in MM/DD/YY format. This is imperative in determining if whether you have at least one year of creditable specialized experience. Dates will not be assumed. GS-12: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-11 in the Federal Service. Specialized experience is demonstrating skill in applying, analytical and evaluative methods and techniques to problems, questions, and/or issues in the areas of fiscal operations and knowledge of the regulations, policies and precedents in relation to disability and survivor compensation payments. Examples of specialized experience include: 1) overseeing and carrying out a broad range of related duties, e.g., evaluating the adequacy and accuracy of compensation and benefit payment systems in relation to claims insurance premiums; 2) providing advice to management and serving as a liaison to other stakeholders including claimants, insurance carriers and other federal agencies; 3) identifying abnormal conditions and initiating corrective actions on insurance premiums and compensation payments.

Education

There is no educational substitution at the GS-12