Basic Function
Performs journey-level workers′ compensation functions in accordance with the California Labor Code and assists employees with work-related injuries return to work and assume their customary duties or to Transitional Duty.
Example Of Duties
- Conducts journey-level investigations upon receipt of new claims
- Reviews and responds to all incoming legal and medical mail on a timely manner in accordance with California Labor Code regulations
- Audits claim files to ensure all benefits have been paid appropriately
- 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
- Maintains claim files on an effective diary system
- Meets with division personnel on a quarterly basis to review open Workers′ Compensation cases
- Works closely with legal to strategize on appropriate handling of claims
- 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
Requirements For Employment
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 - One year of relevant experience examining California Workers' Compensation indemnity claims or related experience in the workers′ compensation industry
Certifications/Licenses/Special Requirements - 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
- Insurance Education Association Certificate and California Workers' Compensation Self-Insured Certificate preferred
- Prior employers′ designation Certificate required in claims handling
Knowledge:
- Theories, principles, and practices of workers' compensation claims administration
- California State Labor Code and other applicable laws, rules, and regulations governing workers' compensation
- American Medical Association Guidelines
- Permanent Disability Ratings
- Applicable business software applications
Skills: - Performing professional workers' compensation claims administration work
- Analyzing situations, identifying problems and issues, and recommending solutions
- Exercising sound judgment when faced with complex issues
- Communicating effectively verbally and in writing
- Interacting professionally with various levels of Metro employees and outside representatives
- Conducting and reporting outcomes of roundtable sessions to discuss cases
Abilities:
- Read and interpret legal reports
- Review and rate medical reports
- Work with legal representatives to resolve matters or cases
- Work aggressively to bring cases to resolution without legal actions
- Handle work assignments and meet time constraints on a strict diary system to ensure deadlines are met
- Organize and prioritize work
- Compile, analyze, and prepare comprehensive management reports
- Use good judgment when handling highly confidential information
- 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
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. (AW)
*Open to the public and all Metro employeesThis 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.
Closing Date/Time: Open Until Filled
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