SENIOR CLAIMS ADMINISTRATOR

  • CITY OF RIVERSIDE, CA
  • Riverside, California
  • Sep 20, 2021
Full Time Customer Service Risk Management and Insurance Claims
  • Salary: $81,456.00 Annually USD

Job Description

The Position

The City of Riverside is accepting applications for the position of SENIOR CLAIMS ADMINISTRATOR to fill one (1) vacancy in the Human Resources Department. The eligibility list established may be used to fill the current and/or upcoming vacancies in this classification for up to six (6) months.

The Senior Claims Administrator, under general supervision, assists in the coordination of the City's self-insured and self-administered Workers' Compensation Program; assists in the supervision of the claims handling and settlement negotiations of claims; communicates with Claims Administrators, physicians and attorneys to resolve claims issues; and performs other related duties as required.
Work Performed
Typical duties may include, but are not limited to, the following:
  • Review, examine and adjust workers' compensation claims.
  • Receive and record all claims and determine compensability.
  • Authorize medical treatment and/or change of physician utilizing California State Workers' Compensation Law.
  • Compute and authorize payments according to California Labor Code.
  • Set reserves.
  • Advise employees and dependents of entitlement to Workers' Compensation benefits under State Law and City policy while maintaining a high level of customer service.
  • Exercise lead responsibility over workers' compensation staff as assigned.
  • Arrange special investigations and medical examinations.
  • Advise supervisors and managers regarding procedures and reporting deadlines involving work related injuries.
  • Coordinate with staff to contact injured employees to explain benefits and legal rights under the Labor Code.
  • Prepare subrogation and litigation cases and correspond with doctors and attorneys on litigated cases.
  • Prepare reports and presentations.
  • Present to City Council in closed session on matters related to Workers' Compensation.
  • Serve as custodian of records; produce records and attest to validity under the direction of the court by subpoena.
  • Develop documentation for claim reports by requesting substantiating reports from physicians, supervisors, and witnesses.
  • Analyze and evaluate complex workers' compensation claims and related issues and present solutions to management and/or City Council.
  • Assist in the development and implementation of Workers Compensation Program metrics.
  • Serve as acting Workers' Compensation Supervisor as required; supervise, train and evaluate work assigned to staff.

Qualifications
Recruitment Guidelines:

Education: Equivalent to an Associate's Degree (60 semester units or 90 quarter units) from an accredited college in business or public administration or a closely related field. Post designation training of up to 30 hours of training in the past two years pursuant to California Code of Regulation-2592.02.

Experience: Three years of progressive experience in the California State Workers' Compensation claims management, reserving, adjusting, analyzing and settling claims in a self-insured environment, with at least one year in a lead capacity.

Necessary Special Requirements
Possession of an appropriate, valid class "C" California Motor Vehicle Operator's License.
Possession of a California State Certification of Claims Administrator.
Selection Process
DOCUMENTS REQUIRED AT THE TIME OF APPLICATION:
1) Completed Employment Application
2) Completed Supplemental Questionnaire
3) Resume

IMPORTANT INFORMATION ON SCHEDULING ASSESSMENTS:
If you are selected to move forward in the assessment process, you may be required to self-schedule your appointment. You will be notified via email of your status and provided with self-scheduling instructions. Please check your email regularly following the closing date of this recruitment.

The selection process will begin with an employment application package screening, with the best qualified candidates being invited to participate further in the assessment process. This process may include any combination of written, performance, and oral assessments to evaluate job-related education, experience, knowledge, skills, and abilities. Those who successfully complete the selection process will be placed on the eligibility list for this classification.

It is the responsibility of candidates with a disability requiring accommodation in the assessment process to contact the Human Resources Department in writing to request such accommodation prior to the closing date of this recruitment.

Appointment may be subject to the successful completion of a pre-employment background investigation, drug screen, and/or medical/physical examination.

NOTE : The City reserves the right to modify selection devices and test instruments in accordance with accepted legal, ethical, and professional standards. Candidates may reapply when there is a posting to establish an eligibility list.

EDUCATIONAL REQUIREMENTS:
Proof of education listed in your application will be requested at the time of conditional offer. Acceptable documentation consists of transcripts or degree, if applicable, by the accredited U.S. college or university.


Education obtained outside the United States (US) require one of the following options:
  1. An equivalency statement from an evaluation company certified by the National Association of Credential Evaluation Services (NACES) at http://www.naces.org/members.html or the Association of International Credential Evaluators Inc. (AICE) at http://aice-eval.org/members/.
  2. An advanced-level degree from an accredited US college or university.
All applicants will be notified via e-mail or telephone of their application status and the assessment dates/times/locations after the closing date of this announcement.

THE PROVISIONS OF THIS JOB ANNOUNCEMENT DO NOT CONSTITUTE AN EXPRESSED OR IMPLIED CONTRACT.

Job Address

Riverside, California United States View Map