Administrative Assistant Ii Workers Compensation Specialist

We are seeking an experienced Administrative Assistant II Workers' Compensation Specialist, Onsite - Madison WI. Pl. go through the below description and let me know your interest. If you are interested, kindly share a copy of your resume to along with the rate / salary and best time to reach you.

Location: Madison, WI 53703 (Onsite)
Work Schedule: Monday Friday, 7:45 AM 4:30 PM
Work Location: 201 E. Washington Avenue, Madison, WI 53703

Job Summary
We are seeking a detail-oriented and highly organized Administrative Assistant II Workers' Compensation Specialist to support the Wisconsin Department of Workforce Development's Workers' Compensation Division. The selected candidate will be responsible for reviewing and processing medical cost disputes, researching healthcare billing and pharmacy fee schedules, maintaining claims documentation, and providing administrative and case management support. This position requires strong analytical, communication, problem-solving, and organizational skills, along with the ability to interpret medical documentation, manage dispute-related correspondence, and work with multiple stakeholders.

Key Responsibilities
1. Workers' Compensation Claims and Medical Cost Dispute Management
Review and analyze medical cost disputes involving healthcare services provided to employees with work-related injuries.
Verify the completeness and accuracy of submitted documentation, including medical charges, billing justifications, and payment denials.
Research and evaluate disputes involving medical fees and pharmacy fee schedules.
Review electronic claims records to determine whether a dispute is associated with an active workers' compensation claim.
Create, associate, and update claim records within electronic claims management systems.
Coordinate with employers, insurance carriers, injured workers, attorneys, and healthcare providers to obtain missing information and facilitate dispute resolution.
Research applicable healthcare fee schedules and prepare draft payment orders in accordance with Wisconsin statutes, administrative rules, and departmental guidelines.

2. Medical Documentation Review and Case Preparation
Review medical reports, treatment records, and supporting documentation related to disputes over the necessity of medical treatment.
Identify disputed issues, including work-related injuries, pre-existing conditions, and treatment eligibility.
Communicate with relevant parties via telephone and written correspondence to obtain clarification and additional documentation.
Prepare and organize case materials for formal review by medical experts or designated review panels.
Monitor disputes associated with active litigation and maintain appropriate case status records.
Document case activities, dispute progress, and resolution updates in Microsoft Excel and electronic claims databases.

3. Administrative and Customer Service Support
Respond to inquiries from injured employees, employers, insurance carriers, attorneys, and healthcare providers regarding workers' compensation claims and procedures.
Explain applicable administrative processes, requirements, and dispute resolution procedures.
Draft professional correspondence, reports, case summaries, and proposed administrative orders.
Maintain accurate electronic records and case documentation for reporting and reference purposes.
Assist with informal dispute resolution discussions and information gathering.
Coordinate with internal teams to ensure timely processing of assigned cases.
Identify opportunities to improve administrative workflows and service delivery.

How to Apply
Interested candidates are encouraged to apply with an updated resume highlighting relevant experience in administrative support, workers' compensation, insurance claims, healthcare billing, case management, or dispute resolution.