Workers' Compensation Claims Technician

ABOUT THE POSITION

The County of Riverside's Department of Human Resources is seeking a Workers' Compensation Claims Technician (No Lost Time Desk) to support the County of Riverside Self Insured Workers' Compensation Program.

The selected candidate will carry an independent caseload of First Aid, Medical Only, Future Medical Workers' Compensation claims and will also identify, analyze and evaluate workers' compensation claims and/or manage the Return-to-Work program.

The most competitive candidates will have recent experience providing support services to workers' compensation claims department and have knowledge of medical terminology, the State of California Labor Code and Workers' Compensation Laws.

Workers' Compensation Claims Technician is characterized by the assigned responsibility to perform adjusting, investigative, and decision making functions for medical only claims, having no permanent disability issues, up to $3,000.

This class is distinguished from the class of Workers' Compensation Adjustor I by the latter's primary responsibility to investigate, adjust, and settle a broad scope of workers' compensation claims that go beyond medical only claims, have a reserve limit of $10,000, and involve permanent disability issues.

Meet the team!

The Human Resources Department strives to effectively serve and partner with our community, departments and employees by leveraging best practices and innovation to foster a thriving county.

EXAMPLES OF ESSENTIAL DUTIES


* Review, investigate, and process "medical only" claims filed against the County; determine the complexity of the claim and identify issues; recommend approval or denial.



* Perform tasks associated with claim filing; set up files; complete appropriate forms and paperwork; make related phone calls to claimants, doctors, and applicable County departments; conduct routine tasks as with claim handling and scheduling medical appointments.



* Review medical reports to ascertain status, need for consultation, additional tests and/or treatment; respond to inquiries, verbally and in writing, received from insurance carriers, doctors, and claimants.



* Maintain and pull diary on medical only claims; pay claims-related medical bills; review file to avoid duplication of payment; post and balance payments; correct trial-posting errors.



* Assist Workers' Compensation Adjustors as needed; may calculate benefits on temporary disability cases and complete notices to payroll based on Adjustor's approval.

MINIMUM QUALIFICATIONS

OPTION I

Medical-Only Claims Adjuster Designation (as defined by California Code of Regulations, Title 10, Chapter 5, Subchapter 3) by achieving one of the following: At least three years in the past five years of on-the-job experience adjusting California workers' compensation claims or medical-only claims.

OR

Completed at least 80 hours of training, with 50 hours conducted in a classroom with an instructor from an accredited college or t...