Workers' Compensation Claims Aide

JOB INFORMATION

See NOTE(S) below for future wage increases and/or additional compensation opportunities.
Workers' Compensation Claims Aide positions investigate, adjust, and settle Workers' Compensation Claims, including Future Medical and Medical Only cases; review and evaluate claims and the medical reports; interview and correspond with claimants, witnesses, and physicians; approve or deny claims; interpret the provisions of State Labor Code laws; and perform other duties as assigned.
NOTES:

• Employees in job classifications represented by Municipal Employees Association (MEA) are scheduled to receive the following general wage increases:

• Eligible benefitted employees originally hired on or after July 10, 2021, will be automatically enrolled in the San Diego City Employees Retirement System (SDCERS).

MINIMUM REQUIREMENTS

You must meet the following requirements on the date you apply, unless otherwise indicated.
EDUCATION/EXPERIENCE: You must meet ONE of the following options:

• Two years of full-time clerical experience, which includes one year of experience providing clerical support for Workers' Compensation Claims, researching billing and payment issues, and maintaining Workers' Compensation files electronically and/or hard copy.
• 18 months of full-time clerical experience, which includes six months of experience providing clerical support for Workers' Compensation Claims, researching billing and payment issues, and maintaining Workers' Compensation files electronically and/or hard copy ANDsuccessful completion of one of the following Insurance Educational Association (IEA) or equivalent agency's classes: Introduction to Workers' Compensation Claims Adjuster (WCCA) 8, WCCA 006, WCCA 10, WCCA 11, WCCA 12, WCCA 14 or WCCA 15.
• 18 months of full-time clerical experience, which includes six months of experience providing clerical support for Workers' Compensation Claims, researching billing and payment issues, and maintaining Workers' Compensation files electronically and/or hard copy AND possession of a valid current designation as a Medical-Only Claims Adjuster in accordance with the California Code of Regulations.

• City of San Diego employees using Out-of-Class Assignment (OCA) experience to qualify must submit written documentation signed by their appointing authority or payroll specialist, detailing the work performed, dates, and total number of qualifying OCA hours. OCA experience without the required documentation will NOT be considered.

• Proof of IEA or equivalent agency's classes, if utilized to meet the minimum requirements.
• Proof of designation as a Medical-Only Claims Adjuster in accordance with the California Code of Regulations, if utilized to meet the minimum requirements.
• For City of San Diego employees, proof of Out-of-Class Assignment (OCA), if utilized to meet the minimum requirements.

SCREENING PROCESS

Please ensure all information is complete and accurate as the responses you provide on the supplemental questions will be reviewed using an automated evaluation system. If you are successful in this initial screening process, your application will be reviewed for applicable education, experience, and/or training to ensure all minimum requirements have been met. Successful candidates will be placed on a list which will be used to fill position vacancies during the next six months (180 days). For each vacancy, only those candidates with the most appropriate qualifications will be contacted by the hiring department for an interview.

SUPPLEMENTAL INFORMATION

PRE-EMPLOYMENT REQUIREMENTS: Employment offers are conditional pending the results of all screening processes applicable to this position, which may include the following: confirmation of citizenship or legal right to work in the United States; completion of a pre-employment medical review and exam (which may include drug and alcohol testing); reference checks; and fingerprinting. Fingerprints will be submitted to the Federal Bureau of Investigation and the California Department of Justice for a conviction record report. Certain positions may require additional screening processes, including a polygraph examination and/or background investigation. All screening processes must be successfully completed before employment begins. A positive test result for alcohol, cannabis/marijuana, illegal drugs, or inadequately explained prescription drugs, or misrepresentation, falsification, or omission of pertinent facts in any step of the screening or selection process, may constitute cause for disqualification or termination of employment. Nothing in this job posting constitutes an express or implied contract for employment with the City of San Diego. Candidates must notify the Personnel Department of any change in their name, mailing address, email address, or phone number, otherwise they may miss employment opportunities.