What are the responsibilities and job description for the ASSISTANT WORKERS' COMPENSATION ANALYST position at LA Metro?
Metro’s mission is to provide a world-class transportation system that enhances the quality of life for all who live, work, and play within LA County.
Description
Under close supervision, performs entry-level workers' compensation functions/processes in accordance with California Labor Code
Examples of Duties
- Conducts entry-level investigations upon receipt of new claims
- Reviews and responds to all incoming legal and medical mail in a timely manner in accordance with California Labor Code regulations
- Audits claim files to ensure all benefits have been paid appropriately
- Provides administrative support in assigned department
- Provides timely and quality customer service to all Metro staff as well as outside providers
- Maintains close working contact with injured employees and division personnel in an effort to return employees to work, or Transitional Duty
- Maintains claim files on an effective diary system
- Works closely with legal to strategize on appropriate handling of claims
- Sets up new claims in the database system and adds pertinent information such as injury codes based on current regulations
- Processes internal and external payments related to claims, such as benefits payments and medical bills; issues reimbursements and credits
- Consults and coordinates efforts with the Analyst, Return-to-Work Coordinator, Medical Case Manager, Human Resources staff, and others as it relates to the transitional duty/return to work process
- Authorizes medical treatment, reviews progress of cases by consultation with Analysts, examining physicians, and assures that treatment is prompt, adequate, and cost effective
- Performs other related duties as assigned
- Contributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of Metro are carried out
May be required to perform other related job duties
Minimum Qualifications
A combination of education and/or experience that provides the required knowledge, skills, and abilities to perform the essential functions of the position. Additional experience, as outlined below, may be substituted for required education on a year-for-year basis. A typical combination includes:
Education
- Bachelor's degree in Business Administration, Human Resources, or a related field
Experience
- None Required
Certifications/Licenses/Special Requirements
- Insurance Education Association (IEA) Certificate, The Workers' Compensation Claims Association (WCCA) Certificate, or California Workers' Compensation Self-Insured Certificate preferred
- A valid California Class C driver license or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions
Essential Knowledge
Knowledge of (defined as a learned body of information that is required for and applied in the performance of job tasks)
- Theories, principles, and practices of workers' compensation claims administration
- California State Labor Code and other applicable laws, rules, and regulations of workers' compensation
- American Medical Association Guidelines
- Permanent Disability Ratings
- Applicable business software applications
Skilled in (defined as the proficient manual, verbal, or mental utilization of data, people, or things)
- Performing professional workers' compensation claims administration work
- Calculating wages
- Analyzing situations, identifying problems and issues, and recommending solutions
- Exercising sound judgement when faced with complex issues
- Communicating effectively verbally and in writing
- Interacting professionally with various levels of Metro employees and outside representatives
Ability to (defined as a present competence to perform an observable behavior or produce an observable result)
- Read and interpret legal reports
- Review and rate medical reports
- Work with legal representatives to resolve matters or cases
- Handle work assignments and meet time constraints and deadlines
- Organize and prioritize work
- Use good judgement when handling highly confidential Information
- Compile, analyze, and prepare comprehensive management reports
- Understand, interpret, and apply laws, rules, regulations, policies, procedures, contracts, budgets, and labor/management agreements
- Travel to offsite locations
- Read, write, speak and understand English
Special Conditions
The physical demands described are representative of those that must be met by the employee to successfully perform the essential functions of this job. Metro provides reasonable accommodation to enable individuals with disabilities to perform the essential functions.
Working Conditions
- Typical office situation
- Close exposure to computer monitors and video screen
- Local travel
Physical Effort Required
- Sitting at a desk or table
- Operate a telephone or other telecommunications device and communicate through the medium
- Type and use a keyboard and mouse to perform necessary computer-based functions
- Intermittently sitting, standing, stooping
- Communicating through speech in the English language required
Metro is an Equal Opportunity Employer and does not discriminate on the basis of race, color, creed, ancestry, national origin, gender, marital status, sexual orientation, religion, age, veteran status, or disability. Learn more about Metro’s Equal Employment Opportunity Program. Metro does not deny participation in the application process to anyone with prior justice system involvement, in line with Fair Chance hiring practices.
Selection Procedure
Applicants who best meet job-related qualifications will be invited to participate in the examination process that may consist of any combination of written, performance, or oral appraisal to further evaluate job-related experience, knowledge, skills and abilities.
Application Procedure
To apply, visit Metro's website at www.metro.net and complete an online Employment Application.
Computers are available to complete online Employment Applications at the following Metro location:
METRO Headquarters, Employment Office
One Gateway Plaza
Los Angeles, CA 90012
Telephone: (213) 922-6217 or persons with hearing or speech impairments can use California Relay Service 711 to contact Metro.
All completed online Employment Applications must be received by 5:00 p.m. on the closing date. Late applications will not be considered.
- Open to the public and all Metro employees
This job bulletin is not to be construed as an exhaustive list of duties, responsibilities, or requirements. Employees may be required to perform other related job duties.
*Please refer to the applicable benefit type (Regular or Temporary)*
We offer a range of high-quality medical, dental and vision plan options as well as health care spending accounts for you and your family. Metro will cover a significant portion of your health care premiums.
Medical/Dental/Vision Plan - Employee has the choice of 3 separate medical plans and 3 dental plans. A separate vision plan is included in each medical plan.
Group Life Insurance - PTSC pays for an amount equal to your annual salary, rounded up to the nearest $1,000. Minimum amount of life insurance is $30,000.
Accidental Death & Dismemberment Insurance - PTSC provides $50,000 coverage for each employee. Additional voluntary coverage in amounts up to $500,000 is available at favorable premium rates.
Long-Term Disability Insurance - 100% employer paid. Provides employees with a minimum income of 60% of earnings after six months of disability. Buy up or buy down options available.
Holidays - 12 days a year: New Year's Day, Martin Luther King, Jr. Day, Presidents' Day, Memorial Day, Independence Day, Labor Day, Veterans' Day, Cesar E Chavez, Juneteenth,Thanksgiving Day, Day After Thanksgiving, and Christmas Day.
Time off with Pay (TOWP) - Compensates employees who are on approved absence from work for reasons such as illness, injury, medical and dental appointments, personal business, vacation, or observance of (a) religious holiday.
Years of Service Annual Accrual
Hire date - 5 years 20 days
Beginning of 6th - 10th year 25 days
Beginning of 11th - 15th year 30 days
Beginning of 16th years 35 days
Pension Plan - PTSC retirement plan is the Public Employees' Retirement System (PERS). Vesting is five (5) years. Minimum retirement age is 52, based on the 2% at 62 formula.
Other Benefits: Transportation passes for employees and/or eligible dependents; Medicare; Tuition reimbursement; credit union membership; SDI; Deferred Compensation Plan; 401(K) Thrift plan; EAP; Medical and Dependent Care Flexible Spending Accounts; Flexible work schedules; and Jury Duty Pay.
- Kaiser medical insurance
- Public Pension Plan
- 457/401K Plan
- Flex Spending
- Paid Sick Time
- Fare Media
- Rideshare Subsidies
- Metro One Fitness membership
One Gateway Plaza
Los Angeles, California, 90012
Salary : $55,390 - $83,054
