Workers' Compensation Claims Examiner

5 days ago

Sacramento, California, United States Sacramento County CA Full time

About the Position

This is a continuous filing exam. Next filing cut-offs are at 5:00 pm on: 6/28/24, 7/19/24 (Final)

Job Summary

Under direction, the Workers' Compensation Examiner performs specialized claims service in the administration of the County's self-insured Workers' Compensation Program. Incumbents in this class administer the indemnity workers' compensation cases; attend conferences and hearings, and adjust cases from inception of injury through litigation to closure.

Key Responsibilities

  • Read, interpret, and apply legislative provisions and administrative procedures in the evaluation of workers' compensation claims
  • Analyze a variety of complex data including medical reports, and make appropriate decisions
  • Compute benefits accurately in accordance with policy and procedure guidelines
  • Establish and maintain effective relationships with injured employees and their families, attorneys, physicians, and County management and supervisory personnel
  • Use good judgment in recommending or approving settlements in litigated cases
  • Read, write, and speak English at a level necessary for satisfactory job performance

Minimum Qualifications

Either:

  • Two years of full-time paid experience in the class of Workers' Compensation Assistant in Sacramento County service.
  • Or:
  • Two years of full-time paid experience adjusting a caseload of or more California workers' compensation indemnity files from inception of injury through litigation to closure.

General Qualifications

Background/Criminal History: The County may access criminal history information on candidates who have accepted a conditional offer of appointment for this class consistent with the provisions of Board of Supervisors Resolution No, Personnel Policies, and applicable federal and state laws. The County shall not consider for employment any candidate who has been convicted of a felony or misdemeanor that relates to or impacts the candidate's ability to perform the job duties of this class unless it is determined that mitigating circumstances exist. For purposes of accessing criminal history information, the candidate will be fingerprinted. A subsequent arrest notification may be obtained.

Driver's License: Some positions in this class require possession of a valid State of California Driver License, Class C or higher, at the time of appointment. Failure to maintain appropriate valid California Driver License constitutes cause for personnel action in accordance with Civil Service Rules. Individuals who do not meet this requirement due to disability will be reviewed on a case-by-case basis.

Certificates/licenses: Incumbents in this class must submit proof of designation as a Claims Adjuster or an Experienced Claims Adjuster pursuant to California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Sections – within 6 months of appointment to the position. Failure to obtain and maintain this certification constitutes cause for termination from the class in accordance with Civil Service Commission Rules.

Probationary Period

The probationary period for this classification is six (6) months.

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