Workers' Compensation Claims Representative I - T11152-201803



Job Details

Workers' Compensation Claims Representative I - T11152-201803
Employer

City of San Diego

Salary

$43,742.40 - $52,936.00 Annually

Location

City of San Diego, CA

Job Type

Varies by Position

Job Number

CS-T11152-201803

Department

1515 - Risk Management

Opening Date

03/09/2018

Closing Date

Continuous

JOB INFORMATION_San

WORKERS' COMPENSATION CLAIMS REPRESENTATIVE I IS NOT AN ENTRY-LEVEL POSITION. IF YOU DO NOT HAVE A VALID DESIGNATION AS A CLAIMS ADJUSTER, EXPERIENCED CLAIMS ADJUSTER, OR MEDICAL-ONLY CLAIMS ADJUSTER IN ACCORDANCE WITH THE CALIFORNIA CODE OF REGULATIONS, YOU WILL NOT QUALIFY FOR THIS POSITION.

Workers' Compensation Claims Representative I positions investigate, review, evaluate, and administer workers' compensation claims; review medical reports; set reserves; file documentation; review and approve medical bills for payment; review accident and injury reports; interview and correspond with claimants, witnesses, attorneys, and physicians; approve claims or recommend denial; and represent the City at various workers' compensation and industrial leave claims actions and hearings; and perform other duties as assigned.

MINIMUM REQUIREMENTS_San

You must meet the following requirements on the date you apply, unless otherwise indicated.
 
EXPERIENCE: One year of full-time professional-level experience investigating, adjusting, and settling workers' compensation claims covered by California law AND possession of one of the following valid designations:  Claims Adjuster, Experienced Claims Adjuster, or Medical-Only Claims Adjuster in accordance with the California Code of Regulations.
 
      NOTES:

  • Experience working for a third-party administrator, insurance company or self-insured public agency or private company is qualifying.
  • Experience working in a law office preparing, negotiating, or settling workers' compensation claims is NOT qualifying.
  • City of San Diego employees using Out-of-Class Assignment (OCA) experience to qualify must submit written documentation signed by their appointing authority or payroll specialist, detailing the work performed, dates, and total number of qualifying OCA hours. OCA experience without the required documentation will NOT be considered.
 
LICENSE:  A valid California Class C Driver License may be required at the time of hire. 
 
HIGHLY DESIRABLE: 
  • Possession of a Self Insurance Administrator Certificate issued by the State of California Department of Industrial Relations.
 
REQUIRED DOCUMENTS (MUST SUBMIT WITH APPLICATION):
  • Proof of designation as a Claims Adjuster, Experienced Claims Adjuster, or Medical-Only Claims Adjuster in accordance with the California Code of Regulations, if utilized to meet the minimum requirements.
  • For City of San Diego employees, proof of out of Class Assignment (OCA), if utilized to meet the minimum requirements.
 
Required documents should be attached electronically to your application. If you are unable to attach at the time of application submittal, you must submit them as soon as possible via fax:  (619) 533-3337; or to the Employment Information Center:  City of San Diego Personnel Department, 1200 Third Avenue - Suite 300, San Diego, CA 92101. Include your name and the title of the position for which you are applying.

SCREENING PROCESS_San

Please ensure all information is complete and accurate as the responses you provide on the supplemental questions will be reviewed using an automated evaluation system.  If you are successful in this initial screening process, your application will be reviewed for applicable education, experience, and/or training to ensure all minimum requirements have been met.  Successful candidates will be placed on a list which will be used to fill position vacancies during the next six months (180 days).  For each vacancy, only those candidates with the most appropriate qualifications will be contacted by the hiring department for an interview.
 

SUPPLEMENTAL INFORMATION_San

PRE-EMPLOYMENT REQUIREMENTS:  Employment offers are conditional pending the results of all screening processes that are applicable to this job, which may include but are not limited to the following:  Confirmation of citizenship/legal right to work in the United States; completion of a pre-employment medical review/exam (which may include drug/alcohol testing); reference checks; and a fingerprint check.  The fingerprints will be submitted to the Federal Bureau of Investigation and the California Department of Justice for a conviction record report.  Certain positions may require additional screening processes which may include a polygraph examination and/or background investigation.  All of these processes must be successfully completed before employment begins.  A positive test for alcohol, illegal drugs, including marijuana, or inadequately explained prescription drugs, misrepresentation, falsification, or omission of pertinent facts in any step of the screening/selection process may be cause for disqualification and/or termination of employment.  Nothing in this job posting constitutes an expressed or implied contract for employment with the City of San Diego.  Applicants must notify the Personnel Department of any changes in their name, address (home, email), or phone number or they may miss employment opportunities.

City employees may be eligible to participate in a benefit program including holidays, vacations, savings and retirement plans, health programs, and other benefits. 

City employees initially hired on or after the effective date of Proposition B, a voter-approved San Diego Charter amendment to modify City employee retirement benefits, will not be eligible to participate in the City’s Defined Benefit Plan administered by the San Diego City Employees’ Retirement System.
 
Benefits may change due to employer-employee contract negotiations.

01
I understand that failure to respond to the following questions in the spaces provided may result in the rejection of my application. In addition, I may miss out on employment opportunities. Résumés are NOT reviewed for assessing the minimum requirements.
  • Yes
  • No
02
I understand that the responses I provide on the supplemental questions will be reviewed using an automated evaluation system and that if I am successful in this initial screening process, my application will be reviewed for applicable education, experience, and/or training to ensure all minimum requirements have been met.
  • Yes
  • No
03
Are you currently working for the City of San Diego as a government/municipal employee?
  • Yes
  • No
04
Have you previously worked for the City of San Diego as a government/municipal employee?
  • Yes
  • No
05
If you have previously worked or are currently working for the City of San Diego, please enter your PERNR.
06
The minimum age for this job is 18, unless you are 17 and a high school graduate. Do you meet the minimum age requirements for this job?
  • Yes
  • No
07
How did you first hear about this employment opportunity?
  • City of San Diego Employment Information Center
  • City of San Diego Facility/Employee
  • Government Jobs.com
  • Facebook
  • Nextdoor
  • Twitter
  • Jobing.com
  • Monster.com
  • Other Website
  • Notified by Mail/Email
  • Job Fair
  • City Employee Association
  • Community Organization
  • San Diego Union-Tribune
  • Los Angeles Times
  • Voice and Viewpoint
  • La Prensa
  • San Diego Asian Journal
  • Other Periodical
  • Jobs Available
  • Government Finance Officers Association
  • Other Professional Organization/Publication
  • Television/Radio
  • Other
08
How many years of full-time professional-level experience do you have investigating, adjusting, and settling workers' compensation claims covered by California law?
  • None
  • Less than 1 year
  • 1 year to less than 2 years
  • 2 years to less than 3 years
  • 3 years to less than 4 years
  • 4 years to less than 5 years
  • 5 years or more
09
Indicate in which of the following areas you have full-time professional-level experience with workers' compensation claims covered by California law.
  • Investigating
  • Adjusting
  • Settling
  • None of the above
10
Describe your full-time professional-level experience with workers' compensation claims, covered by California law, in the following areas: a. Investigating; b. adjusting; c. settling. For each area, specify from which employer the experience was gained, your title, level of responsibility, percent of time spent on each area and the total length of your experience. If you do not have any experience in a specific area, write "None."
11
Do you possess a valid designation as a Claims Adjuster, Experienced Claims Adjuster, or Medical-Only Claims Adjuster in accordance with the California Code of Regulations?
  • Yes
  • No
12
I understand that I must provide proof of designation as a Claims Adjustor, Experienced Claims Adjuster, or Medical-Only Claims Adjuster at the time of application.
  • Yes
  • No
13
Describe your workers' compensation related experience corresponding with the following individuals: a. Claimants; b. witnesses; c. physicians. For each area, specify from which employer the experience was gained, your title, level of responsibility, percent of time spent on each area and the total length of your experience. If you do not have any experience in a specific area, write "None."
14
What is the largest number of OPEN workers' compensation cases you have been responsible for in any given month? Specify from which employer the experience was gained, your title, level of responsibility, percent of time spent performing the duties and the total length of your experience. If you do not have any experience in this area, write "None."
15
What is the largest number of NEW workers' compensation cases you have been responsible for in any given month? Specify from which employer the experience was gained, your title, level of responsibility, percent of time spent performing the duties and the total length of your experience. If you do not have any experience in this area, write "None."
16
Do you possess a Self-Insurance Administrator Certificate issued by the State of California Department of Industrial Relations?
  • Yes
  • No
17
I understand that I am required to submit the following documents at the time of application: Proof of designation as a Claims Adjuster, Experienced Claims Adjuster, or Medical-Only Claims Adjuster; proof of Out-of-Class Assignment (OCA). If you are unable to attach, refer to the "Required Documents" section of the job posting for instructions.
  • Yes
  • No

* Required Question

Employer
City of San Diego
Address
1200 3rd Ave., Suite 300, MS 51P

San Diego, California, 92101
Phone
(619) 236-6400
(619) 236-6358
Website
http://www.sandiego.gov/empopp/

Apply

OnlineApplication

Warning! You are using Internet Explorer 8. Some features of the Online Application are not fully supported in this version. Please upgrade to a later version of Internet Explorer for optimal performance.

Loading ...