What are the responsibilities and job description for the Workers' Compensation Claims Administrator position at City of Compton?
Under the general direction of the Risk Manager, plans, organizes and directs the administration of the Workers' Compensation program providing continuing control, supervision and management of employee injury and illness cases; and performs other related duties.
Works under the general direction of the Risk Manager, serves as Risk Manager in his/her absence, and exercises supervision over subordinate professional, technical and support personnel.
The following essential functions are those that are critical, integral, necessary, crucial, primary and fundamental to the job. Incumbents who possess the requisite skill, experience, education, and other job-related requirements of a position are expected to perform the essential functions of the job with or without a reasonable accommodation.
The following duties ARE NOT intended to serve as a comprehensive list of all duties performed by all employees in this classification, only a representative summary of the primary duties and responsibilities. Incumbent(s) may not be required to perform all duties listed and may be required to perform additional, position-specific duties.
- Plans, organizes, and directs the activities of staff involved in investigating, adjusting and processing of workers' compensation claims.
- Coordinates the investigation of difficult, sensitive and/or complex claims, determines extent of liability and estimates settlement value of claims; recommends the settlement or denial of claims; makes adjustments and settles claims within assigned monetary authority level; and assesses facts and determines necessity for reporting claims to excess insurance carrier.
- Secures reimbursement of costs where recovery rights exist.
- Conducts audits and inspections of workers' compensation claims.
- Assists in reviewing employee accident and injury reports to determine frequency and loss trends and recommends methods or procedures for mitigation.
- Reviews and evaluates the results of pre-employment, annual and return-to-work medical examinations and makes appropriate recommendations.
- Develops, establishes, updates and reviews medical examination policy standards; evaluates, interprets and applies laws regarding the physical examinations of potential employees in determining job suitability and fitness.
- Monitors rehabilitation services and consults with physicians, service providers and department representatives to resolve claims including return-to-work and vocational rehabilitation plans, and disability retirement.
- Prepares and administers the annual budget for the workers' compensation program.
- Ensures compliance with rules and regulations governing Workers' Compensation benefits and self-insurance administration; reviews, evaluates, interprets and applies established law to Workers' Compensation and Safety Disability Retirement programs.
- Coordinates Workers' Compensation program activities and services with those of other departments and outside agencies and organizations; provides staff assistance to the Risk Manager; prepares and presents staff reports and other necessary correspondence.
- Keeps abreast of new trends and innovations in the fields of worker's compensation, disability retirement and pre-employment medical standards.
- Represents the Department to other City departments, elected officials and outside agencies; explains and interprets departmental programs, policies and activities; investigates and resolves sensitive, significant, and controversial issues.
- Prepares, reviews and approves the formal performance evaluation of department staff, and coaches staff for improvement and development; initiates disciplinary action up to and including dismissal as required to correct behavior.
- Composes, reviews, edits and approves all reports including requests for Council action and weekly or monthly reports of departmental activity.
- Attends and participates in professional group meetings; stays abreast of new trends and innovations in the field of risk management.
- Performs related duties and responsibilities as assigned.
Possession of a Bachelor’s degree from an accredited college or university in Business Administration, Public Administration or a related field; AND five (5) years progressively responsible experience in the administration of workers’ compensation claims; OR an equivalent combination of training and experience. Public sector and/or self-insured employer workers' compensation claims experience and supervisory experience are preferred.
Required Licenses or Certifications:
- Must possess a valid California Class C Driver’s License.
- Self-Insurance Administrator’s License is desirable.
- City organization, operations, policies and procedures.
- City Code, City Ordinances, Standard Operating Manual, personnel policies and procedures, and applicable Memoranda of Understanding.
- Federal, state and local laws, codes and regulations related to workers' compensation and disability retirement, including the State of California Labor and Government Codes and Cal-OSHA regulations.
- Jurisdiction, functions and procedures of the Workers' Compensation Appeals Board (WCAB).
- Medical and technical terminology used in industrial injury and illness cases.
- Research methods and resources, including use of the Internet and report writing.
- Personal computers and computer software packages related to database, spreadsheet and word-processing applications.
- Principles and practices of organization, administration and personnel management.
- Principles and practices of budget preparation and administration.
- Researching, evaluating and recommending policies and programs to comply with state laws and regulations.
- Understanding, interpreting, applying and explaining laws, codes, regulations, policies and procedures related to the Workers' Compensation program.
- Developing and administering budgets and monitoring expenditures.
- Supervising, leading, and delegating tasks and authority.
- Operating a personal computer utilizing standard and specialized software.
- Effective verbal and written communication.
- Establishing and maintaining effective working relationships with staff, City departments, elected officials, outside agencies, and the general public.
- Work is primarily performed in a standard office environment.
- Work may be performed outdoors with time spent in moderate to high temperatures (above 90 degrees).
- Work requires lifting, carrying, driving and on occasion climbing (up to 4 feet).
- Moderate finger dexterity and near vision is required.
- Work may involve exposure to wet surfaces, occasional loud noise and dust.
EXAMINATION
The purpose of this examination is to establish an eligibility list to fill vacancies.
Phase one (1) is a written examination (weighted 50%) which will measure all or portions of the above knowledge, and skills. Phase two (2) is an oral examination (weighted 50%) that will be administered by an appraisal panel to evaluate professional qualifications, background and suitability. The oral examination may include graded simulation exercises, writing exercises, and oral presentations. A passing score for each phase is 70%. Each candidate will be notified via mail or e-mail.
The City of Compton reserves the right to utilize alternative testing methods, if deemed necessary. Failure in one phase of the examination shall be grounds for declaring the applicant as failing in the entire examination, and as disqualified for subsequent parts of an examination.
GENERAL INFORMATION TO EXAMINATION APPLICANTS
The City of Compton does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or provisions of services.
Applicants with disabilities who require special testing arrangements must give advanced notice to the Human Resources Department prior to the final filing date.
ELIGIBLE LISTS
Recruitment may be conducted on a (a) promotional basis, (b) open-competitive basis, or (c) promotional and open-competitive basis simultaneously. All candidates who attain an overall score of at least 70.00 (open-competitive) and at least 75.00 (promotional) will be placed in rank order on the relevant eligible list(s).
PLEASE NOTE:
All permanent City employees that attain an overall score of at least 75.00 will be placed on both the promotional eligible list and the open-competitive eligible list. All City employees that attain a score of 70.00 on EACH PHASE of the examination but an overall score of less than 75.00 will be placed on the open-competitive eligible list only.
Each eligible list shall remain in effect one (1) year from the date of its establishment unless it is extended, abolished or exhausted. Whenever possible, three (3) names are certified to fill any one (1) vacant position. No candidate may be certified more than three (3) times for any one classified position. When certifying eligible lists to appointing powers, the promotional eligible list takes precedence over the open-competitive eligible list. A department manager's recommendation for employment is subject to the City Manager's approval.
EXAMINATION APPEAL PROCEDURE
A candidate may, within five (5) days after taking the written examination, file in writing with the City Manager an appeal against any part of the test, citing the item or items against which the appeal is directed, and the reason(s) for such appeal. The Personnel Board will consider appeals from the decisions and ratings of qualifications appraisals (interview) boards if such appeals meet the conditions described in the Personnel Rules and Regulations (Section 6.8).
EXAMINATION RECORDS
All examination papers, including the employment application, resume, and other attachments submitted by candidates are the property of the Personnel Board and are confidential records which may be open to inspection only for purposes and under conditions established by the Personnel Board.
VETERAN’S PREFERENCE
In all entrance examinations (open-competitive only) for positions in the Classified Service, veterans who served in the armed forces of the United States during time(s) of war, and who attain an overall passing score in the examination are allowed additional preferential credit in accordance with the Personnel Rules and Regulations. In order to claim veterans' credit, the applicant must submit proof of service and honorable discharge (showing specific dates of service) on a U.S. Military form (DD-214) at the time of application or not later than the final filing date for the examination.
FRINGE BENEFITS
The City's comprehensive fringe benefits program includes: retirement (Public Employees' Retirement System), medical, dental, life and vision insurances, deferred compensation, sick and vacation leaves, after-hours education reimbursement, ride share program, uniform allowance and other provisions.
Salary : $77,196 - $90,504
