Administrative Assistant II — Workers’ Compensation Health Cost Disputes

We are seeking an experienced Administrative Assistant II . Pl. go through the below description and let me know your interest. If you are interested, kindly share a copy of your resume to View email address on us.fitly.work along with the rate / salary and best time to reach you.

Agency: Wisconsin Department of Workforce Development, Worker's Compensation Division



Location: 201 E. Washington Ave., Madison, WI 53703

Position Summary

Provide professional and administrative support for workers' compensation health cost disputes. Review disputes concerning medical fees, pharmacy charges, and treatment necessity; prepare cases and draft orders; maintain claim records; and assist parties with workers' compensation questions and procedures.

Responsibilities

• Review incoming medical cost disputes for completeness, including supporting medical charges and payment denials.

• Enter and track disputes in Excel and claims databases, associate disputes with existing claims, and initiate claim records when necessary.

• Obtain additional information from employers, insurance carriers, employees, attorneys, and healthcare providers.

• Research certified medical fees and draft payment orders consistent with Wisconsin statutes, administrative rules, and division guidelines.

• Research pharmacy fee disputes and prepare draft final orders for review and signature by authorized officials.

• Review treatment necessity disputes, clarify disputed issues, and compile case materials for expert review.

• Notify parties when health cost disputes are on hold pending litigation.

• Maintain accurate records of case progress and actions.

• Answer technical questions about workers' compensation laws and procedures by telephone and written correspondence.

• Support informal dispute conferences and recommend improvements to policies and procedures.

Knowledge, Skills, and Abilities

• Knowledge of medical terminology and healthcare procedure coding.

• Knowledge of investigative methods, customer service, and dispute resolution.

• Ability to read, interpret, and apply statutes and administrative rules.

• Ability to review medical reports and other supporting documents.

• Proficiency with Excel, computer databases, and document imaging systems.

• Strong written and verbal communication, problem solving, and conflict resolution skills.

• Basic mathematical skills for payment calculations.

• Ability to exercise sound judgment, work with diverse parties, and maintain cooperative working relationships.

Assignment Requirements

• Wisconsin Department of Justice criminal background check before work begins.

• Display an agency-provided photo identification badge.