Workers' Compensation Specialist

Summary The mission of DFEC is to administer the Federal Employees' Compensation Act (FECA) (5 U.S.C. § 8101 et. seq.) by developing and adjudicating new claims for benefits, managing ongoing claims, authorizing and paying medical and compensation benefits to injured worker and survivors, and helping injured employees return to work when they are able to do so. Position is in the Bargaining Unit. Responsibilities -Primary point of coordination, contact, oversight, and problem resolution for compensation payments and insurance benefits. -Provide expert technical advice, support, and recommendations to agency management officials, claims examiners, fiscal operations specialists, administrative staff and federal agency personnel on interpretation of policies, programs, regulations, and statutes concerning insurance benefits. -Serves as the Federal Employees Health Benefits (FEHB/Federal Employees Group Life Insurance (FEGLI)/Federal Employees Dental and Vision Insurance Program (FEDVIP) point of contact for the program's claimants, beneficiaries, insurance carriers and federal agencies. -Serves as a liaison for the Department of Labor's Solicitor's Office on all matters related to third party subrogation payments and surpluses. Assists claims staff with tracking surpluses and administering benefits while surplus is in place. -Pulls reports from Treasury and enters appropriate fiscal data in the compensation system. Posts cash receipts received in the National office to Fund Control Register. These monies come from a variety of different sources such as medical provider, third party recoveries, employing agencies, claimants and OPM. Analyzes reports from the Office of Personnel Management's FEHB Centralized Enrollment Clearinghouse System (CLER). Conducts reconciliation actions on all identified discrepancies -Analyzes operations and, as necessary, develops procedures and processes to help prevent internal fraud and abuse, and improve accountability and efficiency. -Resolves unusual, delicate, or time-sensitive situations, e.g., those involving congressional inquiry or coordination outside the agency. Resolves the most complex and sensitive insurance benefit case issues with unique situations normally not covered under operating norms or procedure -The incumbent may provide guidance and training to branch employees and claims staff on procedures related to FEHB/FEGLI/FEDVIP benefits and how they impact compensation payments. -Reviews policies, practices, written guidance and records to ascertain compliance with DOL and government-wide policy. Identifies areas for improvement and provides guidance and instruction to assist in making improvements. -Keeps accurate records and creates reports for tracking payments to groups specifically identified by the Branch Chief. Requirements Conditions of Employment Qualifications IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE WILL NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Position titles alone cannot be used to determine if you are qualified. Please list dates in MM/DD/YY format. This is imperative in determining if whether you have at least one year of creditable specialized experience. Dates will not be assumed. GS-12: Applicants must have 52 weeks of specialized experience equivalent to at least the next lower grade level, GS-11 in the Federal Service. Specialized experience is demonstrating skill in applying, analytical and evaluative methods and techniques to problems, questions, and/or issues in the areas of fiscal operations and knowledge of the regulations, policies and precedents in relation to disability and survivor compensation payments. Examples of specialized experience include: 1) overseeing and carrying out a broad range of related duties, e.g., evaluating the adequacy and accuracy of compensation and benefit payment systems in relation to claims insurance premiums; 2) providing advice to management and serving as a liaison to other stakeholders including claimants, insurance carriers and other federal agencies; 3) identifying abnormal conditions and initiating corrective actions on insurance premiums and compensation payments. Education There is no educational substitution at the GS-12 Additional Information The mission of the Department of Labor (DOL) is to protect the welfare of workers and job seekers, improve working conditions, expand high-quality employment opportunities, and assure work-related benefits and rights for all workers. Refer to these links for more information: GENERAL INFORMATION, REASONABLE ACCOMMODATIONS, ADDITIONAL DOCUMENTATION, FORMER FEDERAL EMPLOYEES As a condition of employment, all personnel must undergo a background investigation for access to DOL facilities, systems, information and/or classified materials before they can enter on duty: BACKGROUND INVESTIGATION This position is inside the bargaining unit. If the duty location is within the Washington, D.C. metropolitan area, the position will be included in the Local 12, AFGE bargaining unit. If the duty location is outside the Washington, D.C. metropolitan area, the position will be included in the NCFLL bargaining unit. For more information, click Telework Position Information. This is not a remote work position. The selectee will report to an assigned DOL office location on a regular basis and is eligible for participation in telework as determined by management in accordance with DOL policy. Based on agency needs, additional positions may be filled using this vacancy. The Department of Labor may use certain incentives and hiring flexibilities, currently offered by the Federal government to attract highly qualified candidates. Click here for Additional Information. The Fair Chance Act (FCA) prohibits Federal agencies from requesting an applicant's criminal history information before the agency makes a conditional offer of employment. If you believe a DOL employee has violated your rights under the FCA, you may file a complaint of the alleged violation following our agency's complaint process Guidelines for Reporting Violations of the Fair Chance Act. Note: The FCA does not apply to some positions specified under the Act, such as law enforcement or national security positions. Reasonable Accommodation (RA) Requests: If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire Competency Based Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments.