CLAIMS ADMINISTRATOR

  • CITY OF RIVERSIDE, CA
  • Riverside, California
  • Nov 28, 2021
Full Time Customer Service Risk Management and Insurance Claims
  • Salary: $73,872.00 Annually USD

Job Description

The Position

The City of Riverside is accepting applications for the position of CLAIMS ADMINISTRATOR to fill one (1) vacancy with the Workers' Compensation Division 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 CLAIMS ADMINISTRATOR works under general supervision, to examine and adjust claims for the City's self-insured and self-administered Workers' Compensation Program; to monitor claims expenditures; to communicate with physicians, supervisors, employees and attorneys regarding illness or injury related to employment; and to perform other related duties as required.
Work Performed
Duties may include, but are not limited to, the following:
  • Review, investigate, examine, and adjust Workers' Compensation insurance benefit 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 appropriate reserves.
  • Advise employees and dependents of entitlement to Workers' Compensation benefits under state law and City policy.
  • Arrange special investigations and medical examinations.
  • Advise departments regarding procedures and reporting deadlines involving work related injuries.
  • Contacts injured employee to explain benefits and legal rights under the Labor Code.
  • Prepare subrogation and litigation cases and correspond with doctors and attorneys on litigated cases.
  • Attend WCAB hearings and authorize settlements as directed by the Workers' Compensation Supervisor.
  • Serve as custodian of records; produce record and attest to validity under the direction of the court by subpoena.
  • Develop documentation for claims reports by requesting substantiating reports from physicians, supervisors and witnesses.
  • Compile pertinent facts, make thorough analyses, and arrive at sound decisions.

Qualifications
Recruitment Guidelines:

Education: Equivalent to an Associate Art degree (60 semester or 90 quarter units) from an accredited college. Additional qualifying experience may be substituted for the required education on a year-for-year basis.

Experience:Three years of responsible experience in the reserving, adjusting, analyzing and settling claims in a self-insured environment.

Necessary Special Requirement
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