City of San Diego
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Workers' Compensation Claims Representative I - T11152-201803
at City of San Diego
- JOB INFORMATION
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
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.
- 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.
- 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
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
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.Rev. 2 - January 10, 2019 (Removed Job Information Note)