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NEOGOV · 17 hours ago

Claims Examiner

Compton, CA

Full-time

Onsite

Entry, Mid Level

$66K/yr - $77K/yr

2+ years exp

NEOGOV is seeking a Claims Examiner to join the City of Compton's Risk Management Division. The role involves examining and adjusting Workers' Compensation claims, authorizing medical treatments, and advising employees on their benefits and rights.

GovTechHuman ResourcesInformation TechnologySoftware

Responsibilities

Reviews, examines and adjusts Workers' Compensation claims

Receives and records all claims and determines compensability

Authorizes medical treatment and/or change of physician utilizing California State Workers' Compensation Law

Computes and authorizes payments according to California Labor Code, including medical bills, temporary and permanent disability payments

Advises employees and dependents of entitlement to Workers' Compensation benefits under state law and City policies

Arranges special investigations and medical examinations including return to work exams

Advises departments regarding procedures and reporting deadlines involving work related injuries

Contacts injured employee to explain benefits and legal rights under the Labor Code

Prepares subrogation and litigation cases and corresponds with doctors and attorneys on litigated cases

Serves as custodian of records; produces record and attests to validity under the direction of the court by subpoena

Compiles pertinent facts, makes thorough analyses, and arrives at sound decisions

Maintains and enforces all aspects of security and confidentiality of records and information

Performs other duties as assigned or required

Qualification

Workers' Compensation claimsCalifornia Labor CodeMedical terminologyInvestigative techniquesMS Office applicationsAnalytical skillsCooperative relationshipsPersonal computer operationEffective communication

Required

Possession of a Bachelor's degree from an accredited college or university in Business Administration or a related field

Two (2) years of experience adjusting workers' compensation claims with a public agency or third-party administrator

Must possess a valid California Class C Driver's License

Workers' Compensation Certificate of Insurance

City organization, operations, policies and procedures

City Code, City Ordinances, and Standard Operating Manual

State of California Labor Code and Workers' Compensation law

Medical terminology, anatomy, and technical terminology used in the medical profession related to the cause and treatment of occupational injuries and diseases

Investigative techniques, methods and procedures

Vocational rehabilitation processes and programs

MS Office computer applications

Compiling pertinent facts, making thorough analyses or Workers' Compensation claims and arriving at sound decisions

Understanding, interpreting and applying State Labor Code, Workers' Compensation Law, and City regulations

Establishing and maintaining cooperative working relationships with co-workers

Operating a personal computer utilizing a variety of business software

Effective communication, both verbal and written

Benefits

CalPERS Retirement– Secure pension through the California Public Employees’ Retirement System

Lifetime Medical Coverage for Retirees– Fully funded by the City after 5 years of service with CalPers

CalPERS Health Benefits Program– Choice of 10 health plans, with City-paid premiums for employees and eligible dependents (up to the annual Kaiser family rate)

Employer-Paid Vision and Dental Insurance– For both employees and eligible dependents

Employer-Paid Life Insurance– Offered through UNUM

Flexible Spending Accounts (FSA)– For healthcare and dependent care expenses through American Fidelity

Employee-Sponsored Supplemental Benefits– Optional coverage such as life, disability, and accident insurance

Generous Paid Time Off– Vacation, sick leave, and 16* paid holidays per year

4/10 Flexible Work Schedule– Most Administrative roles based at City Hall enjoy a 4-day workweek, with Fridays off*

Educational Reimbursement– Up to $3,000 per fiscal year for tuition and books

Employee Assistance Program (EAP)– Confidential services for personal and professional support

Professional Development Opportunities– Ongoing training and career growth resources