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Are you looking for a CLAIMS EXAMINER? We suggest you consider a direct vacancy at Immediate Office of the Chief of Naval Operations in Pensacola. The page displays the terms, salary level, and employer contacts Immediate Office of the Chief of Naval Operations person

Job opening: CLAIMS EXAMINER

Salary: $51 713 - 68 062 per year
Relocation: YES
City: Pensacola
Published at: Jul 27 2023
Employment Type: Full-time
You will serve as an Examiner in the Medical Care Recovery Unit (MCRU) in the Claims and Torts Litigation Division, Office of the Judge Advocate General (OJAG) of NLSC.

Duties

You will review and analyze medical claims data reported by civilian hospitals, Navy and Marine Corps commands, police authorities and civilian attorneys; research appropriate rules and regulations; and evaluate third-party liability. You will handle all aspects of claims up to the adjudicating authority. You will enter opened cases into a share-drive database via a personal computer. You will communicate with civilian attorneys, insurers, Government attorneys and other Government officials orally and in writing to assert the Government's independent right of recovery, research issues raised, and formulate appropriate responses.

Requirements

  • Must be a US Citizen.
  • Must be determined suitable for federal employment.
  • Must participate in the direct deposit pay program.
  • New employees to the Department of the Navy will be required to successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit e-verify.gov
  • Within the Department of Defense (DoD), the appointment of retired military members within 180 days immediately following retirement date to a civilian position is subject to the provisions of 5 United States Code 3326.
  • Males born after 12-31-59 must be registered for Selective Service.
  • You will be required to obtain and maintain an interim and/or final security clearance prior to entrance on duty. Failure to obtain and maintain the required level of clearance may result in the withdrawal of a job offer or removal.

Qualifications

This position has a selective placement factor that will be used to screen out ineligible candidates.The selective placement factor is: Do you have experience processing affirmative medical care recovery claims and/or utilizing personal injury tort and/or insurance law to determine whether an affirmative action claim should be pursued? If so, please document this clearly within your resume In addition to the selective placement factor. Your resume must demonstrate at least one year of specialized experience equivalent to the next lower grade level (GS-07) or pay band in the federal service or equivalent experience in the private or public sector handling medical care recovery claims OR experience in processing and negotiating claims and liaising with various entities while performing the following: 1) Providing assistance in processing affirmative medical care recovery claims; 2) Utilizing personal injury tort and insurance law to determine whether an affirmative action claim should be pursued; 3) Interpreting legal aspects of case law relating to affirmative claims for medical care; and 4) Communicating both orally and in writing in a professional manner to assist in settlement of medical claims Additional qualification information can be found from the following Office of Personnel Management website: https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/#url=List-by-Occupational-Series Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., professional, philanthropic, religious, spiritual, community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment.

Education

There is no education substitute.

Contacts

  • Address NLSC 1322 Patterson Ave Suite 3000 Washington Navy Yard, DC 20374 US
  • Name: Department of Navy EIC
  • Email: [email protected]