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    Workers' Compensation Claims Processing Specialist - Los Angeles, United States - Los Angeles USD

    Los Angeles USD
    Los Angeles USD Los Angeles, United States

    6 hours ago

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    Description
    Los Angeles Unified School District (LAUSD) is the 2nd largest public school district in the United States. The school district consists of Los Angeles and all or portions of several adjoining Southern California cities. LAUSD educates and empowers all students as future leaders.

    Job Summary

    Los Angeles Unified School District (LAUSD) Workers' Compensation Claims Specialist $35.62-$44.02/hr. Apply at LAUSD is currently seeking well-qualified candidates to fill a Workers' Compensation Claims Processing Specialist position.

    A Workers' Compensation Claims Processing Specialist participates in the claims processing activities of the Workers' Compensation Section of the Division of Risk Management and Insurance Services.

    The Workers' Compensation Claims Processing Specialist I is responsible for:

    Assists in the processing of Workers' Compensation claims, including obtaining, checking, recording, and evaluating information related to employees' work history.

    Evaluates information and reports relative to claims payments. Addresses questions about Workers' Compensation programs, informs employees of their rights and benefits under California workers' compensation laws. Compiles and analyzes claims data and makes recommendations for policy, procedural, legal, and rule changes.

    Gathers information on accident causes and reports on hazardous or dangerous conditions/actions on District property and coordinates with the Office of Environmental Health and Safety to abate the hazards.

    Assists in maintaining on-going oversight of the third-party administrator (TPA) that includes, but is not limited to, requesting investigation activities to verify suspicious claims, questioning and resolving discrepancies, monitoring of medical treatment, and reviewing case reserves for adequacy.

    Provides courteous and expeditious customer service to administrators, employees, and the general public. Reviews and evaluates settlement authority requests and makes recommendations for approval or revision. Acts as a Liaison to the Early Return to Work Unit as required.
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