Career Opportunities

The Workers' Compensation Claims Examiner, under the direct supervision of the Trindel Director of Workers' Compensation ensures access to any and all benefits necessary to cure or relieve the effects of an occupational injury or illness. The Workers' Compensation Claims Examiner administers these benefits as required by the California Labor Code. Effectively works with injured member and medical provider to facilitate the member's recovery while mitigating risk. This is a highly dynamic and collaborative role that requires outstanding customer service and communication skills.

• Ensure timely and accurate liability decisions and benefit provisions
• Initiate "Three-Point Contact" with member county, injured employee and medical provider.
• Initiate, coordinate, and ensure early return-to-work efforts with worker and member. Proactively manage, finalize, and control an inventory of cases.
• Authorize medical treatment with pre-established authority level.
• Review, investigate, analyze, and adjust workers' compensation claims in accordance with current laws and regulations.
• Establish claims reserves and authorize payments with reserving authority limits.
• Review process of claims with members, providing a well-documented action plan and acting as a resource for claims questions and guidance.
• Review and process bills for payment in accordance with the established fee schedule and contractual agreements.
• Attend conferences and hearings as necessary to properly administer resolution of claims.
• Coordinate resolution of claims by preparing legal documents, including stipulations, and compromise and release settlements within authority limits.
• Coordinate with defence counsel on litigated claims, providing records and reports, as necessary.
• Consult with and monitors service providers, such as legal counsel, and medical and vocational counselors.
• Refer appropriate claims for potential subrogation recovery.
• Regularly handles private and proprietary information while maintaining strict confidentiality and protection from unautohorized disclosure.
• Stay apprised of current law changes, court rulings, and other related matters that might affect the handling of claims.
• Perform various routine clerical duties, utilizing standard office equipment to include: maintaining calendars; entering information into databases and spreadsheets; making photocopies; faxing documents; typing; and word processing.
• Will require overnight travel to attend training, meetings and claim file reviews.
• Ensure to keep Director of Workers' Compensation apprised of any and all claims requiring special attention, or that have extenuating circumstances.
• Perform other duties as assigned by the Director of Workers' Compensation.
• Perform all work in a safe and effective manner.

• Knowledge of claims administration, case management and cost containment solutions as applicable to Workers' Compensation rules in California including 4850.
• Excellent organizational skills and attention to detail.
• Effective analytical, problem solving and interpretive skills.
• Excellent oral and written communication skills.
• Demonstrated ethical conduct.