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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00200643 |
Description Activated On: 10/5/2026 3:35:33 PM |
Position Purpose: Describe the primary purpose of this position and how it contributes to the organization’s objectives. Example: Provides clerical and office support within the Division to ensure its operations are conducted efficiently and effectively. Provides clerical and administrative support within the Healthcare Services Review Division, Bureau of Workers’ Compensation to ensure its operations under the Pennsylvania Workers’ Compensation Act are conducted efficiently and effectively. |
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Description of Duties: Describe in detail the duties and responsibilities assigned to this position. Descriptions should include the major end result of the task. Example: Types correspondence, reports, and other various documents from handwritten drafts for review and signature of the supervisor. Under minimal supervision the incumbent functions as a lead worker over moderately complex clerical work related to the division’s main programs: Medical Fee Review, Utilization Review, and Impairment Rating Evaluation (IRE) and performs the following duties: Reviews documents and other information related to payments made by insurers or self-insured employers for medical treatment and the review of medical treatment provided to employees with work-related injuries and illness, includes but is not limited to applications, medical bills and reports, explanation of benefits/review, proof of service, legal documents, etc. Copies, prints, scans, emails, uploads, proofreads, files, and processes mail, etc., maintains office supplies and equipment, and facilitates resource acquisition, purchase orders, and procurement as assigned. Communicates and interacts with external customers/stakeholders such as other divisions in the bureau, healthcare providers, attorneys, employers, insurers, self-insured employers, injured workers, etc. using various methods. Plans, directs, develops, participates, and conducts trainings for internal staff and external customers/stakeholders as assigned. Performs tasks using the Workers’ Compensation Automation and Integration System (WCAIS) and Microsoft Office applications including but is not limited to Outlook, Teams, Word, Excel, OneDrive, Adobe Pro, Share Point, and state and national databases, etc. Participates in WCAIS user acceptance testing and other testing scenarios for clerical roles, WCAIS defect/enhancement design, digital transformation and or other workgroups as assigned. Manages the division’s resource accounts to ensure that customer/stakeholder inquiries are responded to in a timely and professional manner as assigned. Performs various other tasks and duties as required. |
Decision Making: Describe the types of decisions made by the incumbent of this position and the types of decisions referred to others. Identify the problems or issues that can be resolved at the level of this position, versus those that must be referred to the supervisor. Example: In response to a customer inquiry, this work involves researching the status of an activity and preparing a formal response for the supervisor’s signature. Evaluates the appropriateness, completeness, and nature of the information received from stakeholders, and then independently determines the appropriate processes and approaches to be taken regarding each individual situation. Determines when to accept or return applications for medical fee review, when to close utilization review requests after reviewing determination reports, processing utilization review remands, and assigns requests for designation to physicians for impairment rating evaluations. Uses independent judgement to determine the most appropriate next steps for medical fee reviews, utilization review requests, review determination reports, utilization review remands, impairment rating evaluation designations, external stakeholder inquiries, and performs those steps without pre-approval from a supervisor or manager. |
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Requirements Profile: Identify any specific experience or requirements, such as a licensure, registration, or certification, which may be necessary to perform the functions of the position. Position-specific requirements should be consistent with a Special Requirement or other criteria identified in the classification specification covering this position. Example: Experience using Java; Professional Engineer License Experience: Licenses, registrations, or certifications: 1. N/A 2. N/A 3. N/A 4. 5. 6. |
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Essential Functions: Provide a list of essential functions for this position. Example: Transports boxes weighing up to 60 pounds.
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