Job Abstract

This position performs technical work adjusting, analyzing, investigating, and resolving Workers’ Compensation claims cases. The division provides medical and indemnity benefits to injured employees covered by the City’s Self Insured and Self-Administered Workers’ Compensation Program.

The current Risk Management Technician vacancy is on the Workers Compensation team and will administer benefits in accordance with statutory and case law as well as pertinent regulations for an inventory comprised of minor injuries with no lost time.

(Note: Duties may vary dependent upon assignment.)

Investigates all reports of damage to City property and recovers costs from responsible parties (e.g., the public, insurance carriers, and other entities). Tracks recovery efforts to ensure the City receives all recovery payments.

Processes Small Claims Court actions, which includes filing court documents, serving court documents, executing subpoenas, and defending the City's interests in Small Claims Court proceedings.

Adjusts property damage and small liability damage claims, as assigned. Investigates claims in accordance with industry standards, negotiates and recommends claim settlements, and prepares and secures release documents from claimants. Ensures that claim files are properly documented and all appropriate data has been entered into the claims management system.

Reviews, examines and adjusts medical only and future medical workers' compensation claims in accordance with division policies and industry standards. Establishes and
monitors claim reserves. Authorizes workers' compensation benefits within established authorization limits. Ensures that claim files are properly documented, and all appropriate data has been entered into the claims management system.

Documents first aid and exposure to various pathogens cases in accordance with division policies and industry standards.

Tracks insurance certificates for purchase orders and Council approved agreements. Ensures insurance certificates and associated endorsements are current and in compliance with purchase order/agreement requirements.

Coordinates issuance of insurance certificates and appropriate endorsements requested by outside entities or individuals.

Coordinates with the Workers' Compensation unit and other City Departments to return injured workers to modified duty assignments while recovering from injuries. Prepares and tracks forms necessary to manage program. Clarifies injured employees' work restrictions with doctors. Tracks injured employees' medical appointments and provides status information to departments.

Reviews and processes workers' compensation bills in accordance with established fee schedules and service provider contractual agreements. Processes claims payments, including banking transactions.

Assists with implementation of division special projects.

Responds to questions and inquiries from the public and other City Departments.

Provides administrative support to the City's Accommodations Committee.

Provides administrative support to professional staff.

Assists with training and conducting facility inspections in connection with safety and ADA requirements.

Performs other related duties, as assigned.

Knowledge, Ability and Skills:

Knowledge of:
Principles, practices and methods of Risk Management administration.
Records management practices and procedures.
Business English, spelling, grammar and punctuation.
Basic mathematics.
Modern office practices, procedures and equipment.
Effective customer service techniques.

Ability to:
Organize and coordinate claims in accordance with municipal processes and procedures.
Analyze information.
Reconcile figures.
Prepare and present clear and concise recommendations and reports.
Organize and manage accurate files and records.
Learn and utilize computerized spreadsheet and database applications.
Maintain confidentiality of information.
Work independently with minimal supervision and frequent interruptions.
Respond to public inquiries and customer complaints in a tactful and courteous manner.
Communicate effectively, both orally and in writing.
Provide effective customer service.
Establish and maintain effective and cooperative working relationships with City employees and the general public.

Skill in:
Reading, writing, and communicating at an appropriate level.
Dealing effectively with the public with tact and discretion.
Using a personal computer and applicable software applications.

Education, Training and Experience:

Graduation from high school or the equivalent. Successful completion of 30 semester units of college level or vocational school coursework in Business Administration, Social Science, or a closely related field. Completion of relevant and current professional training or coursework in Risk Management Administration is desirable.

Two years of recent, paid work experience performing administrative support duties, at least one year of which must have been in a risk management environment. Additional relevant work experience may be substituted for the required education on a year for year basis.

Licenses and Certificates:
Possession of a valid Class C driver license or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions.

Depending on assignment, may be required to obtain a California Workers' Compensation Claims Administration (WCCA) certification within one year from date of hire.