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Commonwealth of Pennsylvania |
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POSITION DESCRIPTION FOR JOB POSTING |
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Position Number: 00226452 |
Description Activated On: 7/14/2026 1:30:03 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. Administers the Bureau of Workers’ Compensation’s (BWC) Uninsured Employers Guaranty Fund (UEGF) that pays wage losses and medical expenses associated with workers’ compensation claims against uninsured employers. Oversees and reviews the work of claims handling staff and third-party administrator (TPA). Authorizes payments and other claims actions; determines and negotiates settlements within designated authority levels. Participates in resolution hearings and conferences. Collaborates with BWC colleagues and Commonwealth attorneys to identify approaches to reduce liabilities and recover fund payments. |
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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. Administers the Uninsured Employers Guaranty Fund (UEGF) in accordance with applicable laws, regulations, and policies. Oversees the preparation of reports related to UEGF’s financial status, caseload, and transactions. Plans, organizes, and directs the work of UEGF claims handling staff and a Third Party Administrator (TPA). Ensures the effectiveness, efficiency, consistency, and appropriateness of claims processing and financial transactions. Reviews and monitors claim status and details in the Workers’ Compensation Automation and Integration System (WCAIS), ensures accuracy and makes corrections as required. Conducts audits and quality reviews to ensure claims are being administered in accordance with the Workers’ Compensation Act, UEGF policies, and sound claims administration practices. Coordinates and directs actions of UEGF staff and fund TPA regarding claim administration including, but not limited to initiating investigations, scheduling of independent medical exams, requesting utilization reviews, and related actions. Analyzes claims information to determine appropriate settlement value based on facts and circumstances. Initiates settlement discussions with UEGF staff, legal counsel, and fund TPA, as appropriate. Approves disbursements, claims payments, and settlements up to $25,000 (provides recommendations related to payments over $25,000 to Supervisor). Discusses and negotiates settlements (up to designated authority levels) with internal counsel, claimant representatives, and other interested parties. Analyzes claims for appealable issues. Initiates and participates in resolution hearings, mediation conferences, and settlement discussions. Prepares and presents documentation and statements. Determines and authorizes actions and strategies relating to the defense and processing of UEGF claims, in consultation with the BWC Director, legal counsel, and fund TPA, as appropriate. Maintains a working relationship with internal and external legal counsel. Serves as the primary liaison with legal counsel regarding case-specific action plans and making strategic decisions on pending legal actions. Collaborates with attorneys to develop strategies and actions available to reduce or eliminate claims liability via litigation. Works closely with BWC compliance and collections staff and Commonwealth attorneys regarding investigations, collections, subrogation, and recovery matters. Determines if subrogation is to be pursued, assists with oversight of subrogation claim. Coordinates activities relating to efforts to recoup UEGF benefit and expense payments from uninsured employers, responsible insurers, and third parties including, but not limited to, filing of liens and writs of execution. Refers claims to legal counsel as appropriate. Plans, organizes, and directs the work of technical staff that process incoming receipts, handle outgoing payments, and prepare routine and ad hoc reports. Resolves problems, complaints and eliminates program barriers with staff, leadership, attorneys, TPA, and others. Oversees the preparation of records and reports related to UEGF operations, transactions, and financial status. Analyzes trends, projects future funding levels, and develops action plans to address Fund deficiency or stability issues, including recommending of legislative or regulatory remedies. Analyzes and drafts changes in legislation and regulations relating to UEGF assessments and employer compliance. Regularly confers with and provides updates to Supervisor regarding fiscal status, caseload, claims, mediations, fund activities, and related matters. Oversees preparation of routine reports (such as the Governor’s Budget Office report and the Department’s Non-Compliance list) and ad hoc reports in response to executive leadership or legislative inquiries. Performs supervisory responsibilities. Assigns and reviews work. Guides, develops, and mentors staff. Participates in recruitment, selection, promotion, and other personnel decisions. Reviews/approves leave requests; conducts performance reviews; and related responsibilities. Implements, and communicates policies and procedures related to the UEGF. Develops or recommends approval for all documents and communications involving the Fund, including forms, web pages, notifications, and correspondence. Recommends and assists in the development of changes in UEGF policies and procedures. Participates in the design, development, and testing related to WCAIS changes and enhancements related to UEGF. Responds to inquiries and speaks at conferences, meetings, and educational seminars on workers’ compensation and UEGF policies and procedures. Develops presentations and training materials regarding UEGF. Testifies as a witness for the Commonwealth and before administrative bodies, quasi-judicial boards, and the courts as warranted. Travels for meetings and conferences, as necessary. Performs other related duties as assigned. |
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. Work is performed independently within the framework of existing laws and regulations, and the incumbent has decision-making authority regarding most matters in the operation of the UEGF, including expenditures from and recoveries to the fund, up to $25,000. |
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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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