Claims Auditor (reposted 9-16-26)(DOL-STT)
Division of Personnel Government of the VI
St Thomas, VI, VIRJobSeen todaySeen in employer's feed today
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Job overview
The Claims Auditor reviews and audits claimant files and payment activity in the Workers' Compensation program under the general supervision of a higher-level officer. The role covers vouchers, medical recovery payments, and program expenditures, including checking payment accuracy, treatment ceilings, and third-party settlements. It also prepares statistical and monthly reports on expenditures, injury cases, denials, and other program activity.
Skills & qualifications
Skills
Full job description
This is a standard position description for use in the Workers' Compensation program in which the claimants' files are reviewed and audited. Under the general supervision of a higher-level officer, an employee in this class audits all vouchers for payment, files for medical recovery payments, and all expenditures of monies relative to the payment of Workers' Compensation. Duties and Responsibilities: DUTIES (NOT ALL INCLUSIVE) - Audits all orders and vouchers for payment to claimants, medical providers and institutions. - Records checks when they arrive from the Department of Finance. - Verifies that the amount is correct and is made payable to the correct claimant or provider. - Audits files to ascertain that they do not go over the medically established on-island or off-island ceiling for medical treatment. - Provides lien to attorneys for third party settlements. - Verifies the calculation of third party settlements owned to Workers' Compensation. - Prepares various statistical and monthly reports of money expended by the Government Insurance Fund, total cases of injuries received, total questionable, numbers denied, and unusual cases received, along with other figures relative to the program.
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