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People Making
A Difference!

Idaho
State Government


Idaho Industrial Commission

700 S. Clearwater Lane
Boise, Idaho
83712

WEBSITE:
www.iic.idaho.gov/

If you have questions,
please contact us at:

(208) 332-7555

 

EMAIL:
iichumanresources@iic.idaho.gov


Non-Classified Opening

Worker's Compensation Medical Program Analyst

Non-Classified Classification

Idaho Industrial Commission

Open for Recruitment: April 19, 2017 - May 7, 2017
Announcement # NONCLS090268
Salary Range: Approximately $54,000 to $56,000 Annually DOE -Plus Competitive Benefits!

Location(s): Boise

SPECIAL NOTIFICATION:  This position is exempt from classified state service and the rules of the Division of Human Resources and the Idaho Personnel Commission.

The Idaho Industrial Commission is seeking a high-achieving professional to coordinate the worker's compensation medical fee schedule and medical fee dispute resolution program.

RESPONSIBILITIES INCLUDE: This program analyst position is responsible for coordinating the worker’s compensation medical program to include: establishing cooperative working relationships with in-state and out-of-state claims administrator managers and medical providers to ensure top-down compliance with the Idaho Worker's Compensation Law; explaining current laws and procedures regarding fee reimbursement; coordinating between medical providers and payers regarding reimbursement questions or problems; auditing and analyzing worker's compensation sureties, claims administrators, and self-insured; performing medical bill review (MBR) and resolving medical fee disputes; presenting findings, deficiencies and recommendations for improvement to management and stakeholders; providing training to constituent groups both in-state and out-of-state; and providing technical assistance internally and to claims administrators medical providers, and attorneys.

MINIMUM QUALIFICATIONS:

  • Knowledge of insurance, legal, and medical terminology relating to worker's compensation or other medical claims;
  • Experience (or coursework with some experience) with: medical terminology; medical diagnostic and procedural terms; medical payment procedure codes used in CPT, MS-DRG, or APC coding; and Medicare reimbursement; 
  • Experience interpreting, explaining, and applying laws, regulations, and complex policies;
  • Strong verbal and written communications skills including experience conducting group presentations;
  • Experience in dispute resolution and problem-solving;
  • Experience in positions that require accuracy, attention to detail, and good time management skills;
  • Good computer skills (experience with MS Word, Excel, and Outlook preferred);
  • Four-year college degree in a related field or at least three years of recent (within the past 10 years) experience in the insurance/medical industry; and
  • Knowledge of the Idaho Workers’ Compensation Laws preferred (certification as an Idaho Workers’ Compensation Specialist a plus).

For this position, extra consideration will be awarded if the following can be demonstrated:

  • CPC, CIC, COC, or CPC-P Coding Certification
  • Veteran Status
  • Mediation/Negotiation Experience

TO APPLY: Mail or deliver a cover letter and a résumé outlining experience and education to:

       Ms. Dani Spurny, Human Resources
       Idaho Industrial Commission
       700 S. Clearwater Lane
       Boise, Idaho 83712

Application materials (résumé and cover letter) must be postmarked or delivered no later than Sunday, May 7, 2017. These materials will be reviewed to select the most highly qualified candidates to participate in the interview process.

To request any needed accommodation to participate in the application and/or interview process, please call (208) 332-7555 or TDD 1-800-950-2110. 

OVERTIME NOTICE:
At the discretion of the appointing authority, compensatory time off may be provided in lieu of overtime cash compensation.

Hiring is done without regard to race, color, religion, national origin, sex, age or disability. In addition, preference may be given to veterans who qualify under state and federal laws and regulations. If you need special accommodations to satisfy testing requirements, please contact the Division of Human Resources.