Appellate Review Specialist (Compliance Specialist 3)

This position resolves disputes by issuing a legally binding Order on Reconsideration after the completion of a thorough analysis of the claim closure and disputed issues, including compliance with claim closure statute.  In some cases, the position facilitates the dispute by mutual agreement of the parties through negotiation, mediation and/or education.

Here’s what you need to qualify:

Minimum qualifications (required):

• Five years’ experience doing administrative research that included compiling and evaluating facts to recommend management action or decide compliance or eligibility with program guidelines and regulations. Three of the five years must be above the technical support level.

Note: College-level course work may substitute for experience on the basis of 45-quarter units per year, up to a maximum of three years.

Requested Skills:

• Preference may be given to candidates whose work history demonstrates the skills and knowledge necessary for processing and/or management of Oregon Workers’ Compensation claims.
• Demonstrated ability to manage a large caseload composed of medical documents and legal documents
• Demonstrated ability to know and meet strict timelines
• Demonstrated ability to work collaboratively with diverse groups
• Demonstrated skill in analysis and evaluation of medical and/or legal decisions, using professional and impartial judgment in decision making
• Demonstrated ability to interpret policy, rules, statutes and case law
• Preference may be given to those with a strong background in medical terminology and understanding of human anatomy/physiology

Note: You do not need to have all these requested skills to be eligible for this position.