Workers' Compensation Examiner - Sacramento, United States - Sacramento County, CA

Description

Salary : $90, $110,601.36 Annually

Location : Sacramento, CA

Job Type: Permanent Full-Time

Job Number: 28553-C

Department: Personnel Services

Division: Workers' Compensation

Opening Date: 06/07/2024

Closing Date: 7/19/2024 5:00 PM Pacific

The Position

Come join one of Forbes Magazine's Best Employers

This is a continuous filing exam. Next filing cut-offs are at 5:00 pm on:
6/28/24, 7/19/24 (Final)

Under direction, the Workers' Compensation Examiner performs specialized claims service in the administration of the County's self-insured Workers' Compensation Program. Incumbents in this class administer the indemnity workers' compensation cases; attend conferences and hearings, and adjust cases from inception of injury through litigation to closure.
Examples of Knowledge and Abilities

Knowledge of

• Workers' compensation laws, administrative regulations, and major court decisions
• Medical and legal terminology relating to workers' compensation matters
• Methods of evaluating workers' compensation claims and computing benefits

Ability to

• Read, interpret, and apply legislative provisions and administrative procedures in the evaluation of workers' compensation claims
• Analyze a variety of complex data including medical reports, and make appropriate decisions
• Compute benefits accurately in accordance with policy and procedure guidelines
• Establish and maintain effective relationships with injured employees and their families, attorneys, physicians, and County management and supervisory personnel
• Use good judgment in recommending or approving settlements in litigated cases
• Read, write, and speak English at a level necessary for satisfactory job performance

Employment Qualifications

Minimum Qualifications

Either: Two years of full-time paid experience in the class of Workers' Compensation Assistant in Sacramento County service.

Or: Two years of full-time paid experience adjusting a caseload of or more California workers' compensation indemnity files from inception of injury through litigation to closure.

Note: If the word "experience" is referenced in the minimum qualifications, it means full-time paid experience unless the minimum qualification states that volunteer experience is acceptable. Part-time paid experience may be accumulated and pro-rated to meet the total experience requirements.

General QualificationsBackground/Criminal History: The County may access criminal history information on candidates who have accepted a conditional offer of appointment for this class consistent with the provisions of Board of Supervisors Resolution No , Personnel Policies, and applicable federal and state laws. The County shall not consider for employment any candidate who has been convicted of a felony or misdemeanor that relates to or impacts the candidate's ability to perform the job duties of this class unless it is determined that mitigating circumstances exist. For purposes of accessing criminal history information, the candidate will be fingerprinted. A subsequent arrest notification may be obtained.

The County may also conduct a background check on the candidate prior to appointment to a position within this class. The background check may include personal and professional reference checks, credit history checks, Social Security Number verification, professional license/registration verification, military service information and driving history. Information obtained in the course of this background check will be considered by the appointing authority in the selection process. In obtaining such information, the County will comply with applicable consent and disclosure practices in the Fair Credit Reporting Act and the California Investigative Consumer Reporting Agencies Act.

Driver's License: Some positions in this class require possession of a valid State of California Driver License, Class C or higher, at the time of appointment. Failure to maintain appropriate valid California Driver License constitutes cause for personnel action in accordance with Civil Service Rules. Individuals who do not meet this requirement due to disability will be reviewed on a case-by-case basis.

Certificates/licenses: Incumbents in this class must submit proof of designation as a Claims Adjuster or an Experienced Claims Adjuster pursuant to California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Sections within 6 months of appointment to the position. Failure to obtain and maintain this certification constitutes cause for termination from the class in accordance with Civil Service Commission Rules.

Probationary PeriodThe probationary period for this classification is six (6) months.
Application and Testing Information

APPLICATION

Qualified applicants are encouraged to apply immediately. All applicants must complete and submit an online County of Sacramento employment application by 5:00 PM on the posted cut-off date. Click to apply.

County of Sacramento
Department of Personnel Services
Employment Services Division
700 H Street, Room 4667
Sacramento, CA 95814
Phone ; 7-1-1 California Relay Service
Email
Inter-Office Mail Code:

• Employment applications and all documentation requested in this announcement must be submitted by 5:00 p.m. on the cut-off date.
• Employment Services is not responsible for any issues or delays caused by an applicant's computer or web browser. Applicants will be automatically logged out if they have not submitted their applications and all documentation prior to 5:00 p.m. on the cut-off date.
• Your application should highlight all relevant education, training, and experience, and clearly indicate how you meet the minimum qualifications for the position as of the cut-off date.
• Application information must be current, concise and related to the requirements in this job announcement. You may only apply for this recruitment once. Duplicate and incomplete applications will be disqualified.
• A resume may be included with your application, however it will not substitute for the information requested on the application.

SUPPLEMENTAL QUESTIONNAIRE

Applicants are required to provide a full and complete response to each supplemental question. The Supplemental Questionnaire is located in the tab marked "Supplemental Questions". Please be descriptive in your response.

Note: Responses of "See Resume" or "See Application", or copy and paste of work experience are not qualifying responses and will not be considered.

• Supplemental Questionnaires must be submitted by 5:00 p.m. on the cut-off date. Employment Services is not responsible for any issues or delays caused by an applicant's computer or web browser. Applicants will be automatically logged out if they have not submitted their applications and all documentation prior to 5:00 p.m. on the cut-off date.
• The supplemental questions are designed to elicit specific information regarding a candidate's experience, education, and training. Responses should be consistent with the information on your application and are subject to verification.
• Please provide place of employment, pertinent dates, and concise, descriptive and detailed information for each question.
• If a job included responsibilities applicable to several questions, separate the different functions of the job to answer all the questions completely.
• Resumes or referral to the application or other questionnaire responses will not be accepted in lieu of completing each question.
• If you have no experience, write "no experience" for the appropriate question.
• For many individuals, it is more efficient to develop responses to the supplemental questions in a word processing document and then paste them into the final document to be submitted. Changes or corrections to your Supplemental Questionnaire cannot be made once your application packet has been submitted.
• If the Supplemental Questionnaire is used in the Formula Rate exam, failure to complete all of the questions or incomplete responses will result in a lower score. While scoring the Supplemental Questionnaire, the candidate's application and/or attachments will not be reviewed, therefore, a candidate's responses to the questions should be accurate, thorough, detailed, and complete.

FORMULA RATE EXAMINATION (Weighted 100%)

All candidates meeting the minimum qualifications by the cut-off date will have their Supplemental Questionnaire scored in the Formula Rate Examination.

This examination will evaluate the relevance, level, recency, progression and quality of candidate's education, training and experience. The candidate's application or other materials will not be included in this examination. Therefore, the candidate's responses to the supplemental questionnaire should be thorough, detailed and complete. The score from the Formula Rate Examination will determine the ranking on the eligible/employment list for this job.

All candidates competing in the testing process will receive written notice of their examination results by email. Notices can also be accessed in their inbox. Applicants achieving a passing score will be placed on the eligible list in rank order. The rank is determined by the test score attained from the examination.

FREQUENTLY ASKED QUESTIONS

Click for Frequently Asked Questions (FAQ's)

For information regarding County jobs:

Applicants requesting reasonable accommodations during employment examinations: For more information, please review the and submit an Employment Exam Reasonable Accommodation

EMPLOYEE BENEFITS

As an employee of the County of Sacramento, there will be a variety of benefits available to you. These benefits currently include: health, dental and life insurance; flexible spending account options for dependent care and unreimbursed dental and/or medical cost; and an employee assistance program (EAP).

GENERAL BENEFITS:
Most employee benefits are similar to the following for all County employees. However, some benefits differ, depending on the employee representation unit to which the employee's job classification is assigned. Information about the exact benefits applicable to a particular job classification may be obtained from the Sacramento County Department of Benefits or by visiting

TEMPORARY POSITIONS:
Most benefits do not apply to temporary positions. The explanations of benefits applies to employees in regular positions.

SALARY STEP INCREASES:
The beginning salary and the top of the salary range are usually shown on the job announcement. Upon satisfactory service, salary increases of approximately 5% are given annually until the top of the salary range has been attained.

PAY:
All employees are paid bi-weekly via direct deposit into the employee's bank account. The pay period covers fourteen (14) calendar days, starting on a Sunday and ending on the second Saturday thereafter. Salaries are generally paid on the Friday following the end of the pay period. Employees can set up their direct deposit and access their pay information via Employee Self Service in MySacCounty.

VACATION:
Generally, vacation with pay begins at 10 days annually. With increase over a period of years, the maximum annual vacation with pay is 25 days.

HOLIDAYS:
14.5 holidays per year as recognized.

SICK LEAVE:
Equivalent to 15 days annually, unlimited accumulation. Upon retirement, unused sick leave is converted to retirement service credit.

PARENTAL LEAVE:
Entitles a regular County employee, with at least one year of continuous employment, to schedule a paid parental leave of up to 160 hours upon the birth or during the process of an adoption of a minor child. Parental leave shall be approved by the employee's appointing authority, except where the granting of the parental leave request would unduly interfere with or cause severe hardship upon department operations.

TUITION REIMBURSEMENT:
Dependent upon union agreements, regular County employees may be eligible to receive Tuition Reimbursement. The costs for course tuition/registration fees and required books/supplies are eligible for reimbursement. Tuition reimbursement amounts may vary depending upon union agreement.

RETIREMENT:
Social Security and Sacramento County Employees' Retirement System coverage.

HEALTH INSURANCE:
The County offers a variety of health plan design options to fit individual needs.

DENTAL INSURANCE:
The County provides a comprehensive dental benefit program for regular full-time and part-time employees and their eligible dependents. This plan pays on a set fee schedule that varies by procedure. Any amount over the fee schedule is the employee's responsibility. The yearly maximum is $2,000 per person, not including orthodontia. The orthodontic benefit is 50% of covered charges with a lifetime maximum of $1,000 per person.

LIFE INSURANCE:
The County of Sacramento provides a basic life insurance benefit of $15,000 to all eligible employees at no cost. Additional coverage may be purchased through payroll deduction.

DEFERRED COMPENSATION:
The County offers a Deferred Compensation Program which enables employees to save in a systematic way without paying income tax on either the payroll deduction or the earned interest, prior to withdrawal.

EMPLOYEE ASSISTANCE PROGRAM:
The County of Sacramento provides an Employee Assistance Program (EAP) for employees and their eligible dependents. The EAP offers confidential, professional counseling services in areas such as:

• Legal Advice/Difficult Decisions
• Marriage or Family Relationships
• Financial or Credit Worries/Elder Care
• Alcohol and Drug Abuse

WELLNESS INCENTIVE PROGRAM:
The County will recognize and award time off to eligible employees who maintain an excellent attendance record.

FLEXIBLE SPENDING ACCOUNT:
The County offers regular employees two separate Flexible Spending Accounts (FSA's). These accounts allow employees to set money aside, on a pre-tax basis via payroll deduction, to pay for medical, dental or dependent care expenses.

• DEPENDENT CARE REIMBURSEMENT ACCOUNT:
  Employees may set aside pre-tax dollars to pay for qualified childcare or dependent care expenses that are necessary for the employee and/or spouse to continue working.
  
  
• MEDICAL REIMBURSEMENT ACCOUNT:
  The Medical Reimbursement Account allows pre-tax dollars to be set aside to pay for out-of-pocket expenses that are not paid by insurance or reimbursed by any other benefit plan.

WORKERS' COMPENSATION:
In case of injury while on the job, each employee is protected under the Workers' Compensation laws of California.

SACRAMENTO CREDIT UNION:
The credit union offers loan facilities and systematic saving plans through payroll deduction.

SELECTION AND PLACEMENT

Sacramento County encourages applications from all persons regardless of race, color, ancestry, religious creed, national origin, gender, disability, political affiliation, or age.

Certain age limits may be required by law, ordinance, or Civil Service direction for specific classifications such as those identified with hazardous occupations.

MINIMUM QUALIFICATIONS:
Please read carefully the "Minimum Qualifications" section of your announcement. You must meet those qualifications by the application deadline date unless otherwise specified. Your application must clearly show you meet the minimum qualifications by the application deadline date, or it will not be accepted. All statements are subject to verification.

"Experience" means full-time paid experience unless the announcement states that volunteer experience is acceptable. Part-time paid experience may be accumulated and pro-rated to meet the total experience requirements.

PROMOTIONAL EXAMINATIONS:
If the announcement indicates the examination is given on a promotional basis, candidates must hold permanent status in Sacramento County Civil Service by the application deadline date and must meet the minimum qualifications.

OPEN EXAMINATIONS:
Any person who meets the minimum qualifications may apply.

CONTINUOUS FILING EXAMINATIONS:
Applicants are eligible to reapply to and retake a continuous filing exam after 6 months from the date the previous exam results was received.

ELIGIBLE LISTS:
Names of qualified persons who made a passing score on an examination are entered, in order of their final grades, on an eligible list. To fill each vacancy, the hiring department will make a selection from among the top three ranks on the employment lists.

EXAMINATION RATINGS:
Unless otherwise stated on the announcement: To be successful, candidates must obtain a rating of at least 70% on each part of the examination. This may be an adjusted score or an arithmetic 70% of the total possible score as determined by the Director.

APPEAL PROCESS:
Persons who believe their applications have been improperly rejected may request the Employment Services Division to review its decision to reject the application. If the applicant desires to submit additional proof of qualifications, such proof must be received by Personnel Services not less than two (2) calendar days prior to the scheduled date for the examination.

Persons who are disqualified in any phase of the examination may appeal such adverse action, in writing, to the Civil Service Commission, 700 H Street, Room 2640, Sacramento, CA 95814, telephone: Such appeals must be filed within thirty (30) calendar days after notice of the adverse action was mailed to the candidate.

FOR MORE INFORMATION PLEASE VISIT OUR FREQUENTLY ASKED QUESTIONS (FAQs):

OTHER INFORMATION

VETERAN'S PREFERENCE:
Military veterans who have served during wartime shall be given preference in initial appointment to County service. Such preference shall apply, provided the veteran has first achieved a minimum passing score in the examination. The passing score of a veteran shall be annotated to indicate the veteran's score shall be regarded as 5 points or higher, OR 10 points higher for disabled veterans, only for the purpose of determining the three ranks along with which the veteran's name shall be certified. No score shall actually be changed and no new rank shall be created as a result of application of veteran's preference for certification purposes.

"Disabled Veteran" means any veteran who has served during wartime and, who, as of the final filing date for an examination is declared by the United States Veterans Administration or military service department to be 10% or more disabled as a result of his/her military service. Persons claiming eligibility for disabled veteran's preference must submit to the employment office, on or before the application deadline date, a certification from the United States Veterans Administration or a military service department, dated within 1 year, which certifies the present existence of a service related disability of 10% or more, or other acceptable proof of such disability as a result of his/her military service.
Persons claiming eligibility for veterans preference must submit a copy of Form DD 214 or other acceptable proof of veteran's status on or before the final filing date for the examination. For purpose of this rule "reserve" status does not constitute active duty.

CITIZENSHIP OR AUTHORIZED ALIEN REQUIREMENT:
As required by the Immigration Reform and Control Act, all County employees must be United States citizens or aliens lawfully authorized to work in the United States. Proof of citizenship or authorized status will be required prior to appointment.

CONFLICT OF INTEREST CODE:
Some County Civil Service positions are covered by financial disclosure requirements intended to identify potential conflicts of interest.

CONCURRENT EMPLOYMENT:
No employee may concurrently occupy more than one County position.

SPECIAL SKILL QUALIFICATIONS (WHEN SPECIFIED ON THE APPLICATION):
Persons who have special skills required by some (but not all) positions in a class may be certified ahead of others provided that:

Such special skills are based on the duties and requirements of the positions and are in conformance with merit system and equal opportunity principles, and
The certification of eligibles who possess special skills have been approved by the Civil Service Commission.

PRE-EMPLOYMENT MEDICAL EXAMINATION & DRUG TESTING:
The County of Sacramento is committed to maintaining a drug and alcohol free workplace. All persons selected for appointment to positions must pass a medical examination and a drug test, administered by the County at no cost to the applicant.

DRIVER LICENSE:
Possession of a valid California Driver License may be required for some positions.

PROBATIONARY PERIOD:
Regular positions are subject to a probationary period which is an extension of the selection process. Unless otherwise indicated on the announcement, the probationary period is six (6) months.

AGENCY SHOP/FAIR SHARE FEE:
Some positions require, as a condition of continued employment, that the person either:
1. Become a union member;
2. Pay a fair share fee to the union; or,
3. Meet specific requirements under which an equivalent amount must be paid to a charity.

FINGERPRINTING AND CRIMINAL RECORD CHECKS:
Fingerprinting and criminal record checks are required for some positions.

01

The following Supplemental Questionnaire is the Civil Service Exam for this position and will be used to determine your exam score.
Note: The Supplemental Questionnaire and the Application are administered as two separate documents. The Application is used only to determine if the minimum qualifications are met; and the Supplemental Questionnaire will be used only to determine your exam score.
In order to receive every consideration in the selection process, you must complete all questions with concise but detailed answers and provide all requested information. Each answer will be scored separately. References such as 'See Resume' as a response will not be scored.
By continuing in the exam process, you are certifying that all information provided in the Supplemental Questionnaire is true to the best of your knowledge.

• I have read and understood the above instructions.

02

Select the one box that describes your work experience as it pertains to the position of Workers' Compensation Examiner.

• None.
• Experience as a Workers' Compensation Assistant in Sacramento County service.
• Paid experience adjusting a caseload of 150 or more California workers' compensation indemnity files from inception of injury through litigation to closure.

03

Select the one box that best describes your experience administering workers' compensation claims.

• None.
• Some experience, but less than two (2) years.
• Two (2) years but less than three (3) years of full-time paid experience.
• Three (3) years but less than five (5) years of full-time paid experience.
• Five (5) years or more of full-time paid experience.

04

Select the one box that best describes your current claims adjuster designation.

• Designation as a Medical Only Claims Adjuster.
• Designation as a Claims Adjuster.
• Designation as an Experienced Claims Adjuster.
• None of the above.

05

List the date you were originally designated, the continuing education classes you have taken within the last two years, and the number of hours earned in each training.

If you selected that you have a current designation in the previous question, you will be asked to show proof of your designation at the time of interview.

If you have no current designation, please write "None".

06

Select all the boxes that best describe other relevant active California licenses and/or certificates you currently possess.

• California Driver License, Class C or higher.
• Self-Insurance Administrator's Certificate.
• Workers' Compensation Claims Administration Certification (WCCA).
• Workers' Compensation Claims Professional Certification (WCCP).
• Other.
• None of the above.

07

Select the one box that best represents the type of claims you have worked with on a daily basis within the last five (5) years.

• Medical only claims.
• Indemnity benefits claims.
• My experience is from more than five (5) years ago.
• None of the above.

08

Select the one box that best represents the type of claims you have worked with on a daily basis for the majority of your claims experience over the last five (5) years.

• Insured claims
• Self-insured claims with a third party administrator.
• Self-insured, self-administered claims.
• None of the above.

09

Select all the boxes that represent the different types of claims you have handled in the past five (5) years.

• AOE/COE (arise out of employment/course of employment determinations).
• Cancer claims.
• Catastrophic claims.
• Continuous trauma.
• COVID-19 claims.
• Death claims.
• Disability ratings.
• Early return to work planning.
• Heart claims.
• Multiple body parts claims.
• Presumptive injuries applicable to safety officers (LC Sections
• Psychiatric claim.
• Subrogation.
• Supplemental job displacement benefits.
• Workers' Compensation fraud.
• None of the above.

10

Select all of the boxes that indicate the computer programs you are proficient in and use on a regular basis. You may be required to perform tasks with these items during the interview process to determine your proficiency.

• Microsoft 365.
• Microsoft Access.
• Microsoft Excel.
• Microsoft Outlook.
• Microsoft PowerPoint.
• Microsoft Teams.
• Microsoft Word.
• Risk management software (e.g. OnBase).
• Claims software (e.g. NavRiskClaims/Ventiv).
• Other software.
• None of the above.

11

Describe in detail your training and experience that qualifies you for the Workers' Compensation Examiner position. In your response, please include the following:

• Your employer(s), dates of employment, job title(s)Your experience administering workers' compensation claims (identify public or private sector), litigated and non-litigated claims, and your role in the process
• Description of your experience with claims per your selections in Question 9, including investigating, administering, and negotiating the settlement

Please include in your response any information needed to further clarify your selected responses to any of the previous questions.

If you have no relevant experience, please write "None".

12

The County of Sacramento is committed to maintaining a drug and alcohol free workplace. All persons selected for appointment must pass a drug test administered by the County and at no cost to the applicant.

I understand, if offered conditional employment, I will be subject to a drug test administered by the County as described in Sacramento County Personnel Ordinance Section

• Yes.
• No.

13

I have read the General Requirements and Other Requirements as stated on the job announcement.

• Yes.

Required Question