About PRISM

Senior Workers' Compensation Claims Specialist

One of the CSAC EIA’s greatest assets is its staff. EIA employees are smart, creative, hard working, and passionate individuals working in areas ranging from loss prevention, claims administration, information technology, accounting, and risk pool administration.  Working here requires energy, commitment, and teamwork. At the same time, we offer a great work environment built upon our Core Values of People, Families, Trust, Integrity, and Growth.  We are looking for an individual who shares these values to join the EIA team.

About CSAC Excess Insurance Authority

The EIA is a joint powers authority of California public entities, which was established in 1979 to provide insurance and risk management services to California’s counties. Since then, our membership has expanded beyond the counties to include numerous other public agencies such as cities, schools, joint powers authorities, fire districts, etc.                                                              

The EIA operates various risk-sharing pools, which provide insurance and risk management services to its members for lines of business including workers’ compensation, general liability, property, medical malpractice, and employee benefits.

About the Position

The Senior Workers’ Compensation Claims Specialist will, under the direction of the Workers’ Compensation Claims Manager, maintain a case load of excess workers’ compensation claims and provide oversight of TPAs and claims processes on the primary claims in our Primary Workers’ Compensation (PWC) program.  The Senior Workers’ Compensation Claims Specialist will assist the EIA members, staff, legal representatives, and associated personnel with the discovery and settlement of claims; report cases with potential exposure above EIA coverage to requisite carriers; update information concerning claims and maintain claims in a paperless environment; prepare correspondence; contact member agencies concerning claims status and information; and do related work as required.

The Senior Workers’ Compensation Claims Specialist will review and monitor  claims for proper settlement within the member agency, EIA, and excess carrier coverage levels; contact and discuss potential defenses and settlement strategies with member agency personnel, legal representatives, settlement specialists and claims representatives;  attend and provide input for settlement conferences, defense counsel meetings, and court hearings on cases within the scope of EIA coverage; review insurance policies, governing documents and program policy statements for applicability of coverage on specific claims; review and recommend modification to claims reporting procedures to ensure best availability of information for all concerned parties; ensure that member agency personnel are in compliance with reporting requirements; present cases and settlement recommendations as well as program related matters and recommendations to the Primary Workers’ Compensation and Claims Review Committees; ensure proper reporting of claims to excess carriers above the EIA coverage levels; reconcile claims for reimbursement; monitor and direct subrogation efforts; enter data into the Authority computer system and update current records as necessary; generate requisite reports from the claims system; assist with the preparation of the agenda for the Primary Workers’ Compensation and Claims Review Committee; contact member agencies and TPAs concerning the status of claims and information requirements;  and attend Board and Committee meetings as required.

An important aspect of this position is enhancing the quality of claims services to our member entities.  The Senior Workers’ Compensation Claims Specialist is responsible for quality assurance by performing a liaison role with TPAs and members, conducting on-going field audits as well as on-line audits of TPAs in the PWC program, participating in regular file reviews and making recommendations to management and governing committees on ways to improve claims services.  Up to 25% of travel may be required.

Ideal Candidate

The ideal candidate will have a Bachelor’s Degree in directly related field or equivalent and five years increasingly responsible work in directly related field; or, an equivalent combination of education and experience sufficient to successfully perform the essential duties of the job, including but not limited to:

• Proficient in Microsoft Office including Word and Excel
• Experience working with a RMIS system (Valley Oaks, David Systems, ATS, etc.)
• Ability to set priorities and handle multiple projects simultaneously
• Ability to handle basic arithmetical calculations
• Ability to conduct research, analyze and interpret information
• Ability to establish and maintain effective working relationships and good public relations with other employees, agencies, members, and the public
• Knowledge of applicable laws and regulations
• Knowledge of research and evaluation techniques
• Completion of specialized educational training and courses related to insurance claims adjusting, reporting, settlement, and management are highly desirable
• Public agency claims experience is highly desirable

Physical Requirements

Physical requirements of this position typically include:  sitting for long periods of time, reaching, grasping, kneeling, talking, hearing, seeing, repetitive motions, exerting up to 30 pounds of force occasionally and/or up to 10 pounds of force frequently, and/or negligible amount of force constantly to move. Up to 25% of travel may be required.

Licensing Requirements

A valid California Driver’s license is required.  Proof of auto insurance with no business exclusion is required.  Possession of SIP certification issued by the State of California is required.  WCCP certification is desired.

Salary and Benefits

The hiring salary range for this position is $5,985 - $7,332 per month.  A generous benefit package is provided including Public Employees Retirement System (PERS); a Section 125 Cafeteria Plan with coverage options including health, dental and vision; long-term disability and short-term disability insurance; life insurance; optional deferred compensation program; and sick and vacation leaves.  As a PERS participant, EIA employees are exempt from paying Social Security except for the Medicare portion of the cost.

Application Procedure

Interested persons must submit a resume and a completed application to the Human Resources Manager at CSAC Excess Insurance Authority by Friday, October 21, 2016. Please visit our website at www.csac-eia.org to obtain an application.   Please submit the entire application packet to abateman@csac-eia.org. 

Interview Schedule

Applicants will be contacted regarding the status of their application during the week of October 24, 2016.  Interviews for this position will be conducted from November 2, 2016 – November 4, 2016. 

Job Application

Job Description