Workers Compensation Assistant

Easterseals Southern California transforms lives every day. For over a century, Easterseals has championed inclusion and independence—delivering essential services like early childhood programs, autism services, employment and independent living support to more than 29,000 people each year. Through advocacy and education, we break barriers and create opportunities for the one-in-four Americans with disabilities.

The Workers’ Compensation Assistant supports the timely, accurate, and consistent processing of workers’ compensation reports of injury in partnership with the Workers’ Compensation Manager. This position gathers additional information from supervisors as needed, inputs injury information into the insurance carrier’s system in accordance with applicable legal statutes, internal policies, provisions, and company guidelines, and obtains and confirms work status information. Through these responsibilities, the position supports ESSC’s mission and values by contributing to a safe, compliant, and responsive workplace injury management process.

Starting Pay Range: $27.40/hr. - $32.93/hr.
OVERVIEW OF POSITION:

The Workers’ Compensation Assistant supports the timely, accurate, and consistent processing of workers’ compensation reports of injury in partnership with the Workers’ Compensation Manager. This position gathers additional information from supervisors as needed, inputs injury information into the insurance carrier’s system in accordance with applicable legal statutes, internal policies, provisions, and company guidelines, and obtains and confirms work status information. Through these responsibilities, the position supports ESSC’s mission and values by contributing to a safe, compliant, and responsive workplace injury management process.

ESSENTIAL FUNCTIONS:

- Ensures all claims are handled consistently and processed consistently in accordance with established procedures and claim handling guidelines.
- Partners with the Workers’ Compensation Manager to review reports of injury, determine whether sufficient information is available, and analyze claim information and applicable workers’ compensation guidelines to support eligibility determinations in accordance with claim management principles.
- Maintains thorough documentation of investigation findings and claim-related activity in accordance with state statutes, claim handling guidelines, and best practices.
- Leverages internal and external resources as needed to support timely, appropriate decisions within assigned authority and help limit organizational exposure; coordinate with internal departments, including Payroll, HR, and service line managers, while claims are active.
- Serves as a point of contact for supervisors and the insurance carrier by responding to questions regarding claim filing status.
- Serves as a point of contact for injured workers and clinics to support timely claim-related communication.
- Assists the Workers’ Compensation Manager with supervisor communication to gather additional information as needed.
- Obtains and confirm work status information, including work restrictions and potential accommodation considerations.
- Maintains accurate electronic claim files and claim-related documentation; prepare monthly, quarterly, and ad hoc reports summarizing claim counts, trends, costs, and other relevant data; and serve as the lead backup for team responsibilities as needed.
- Follows applicable laws, regulations, policies, and procedures, and reports potential compliance or risk concerns through appropriate channels. Uses time, materials, equipment, and other resources responsibly and efficiently. Performs other duties as assigned.

EDUCATION:

- High school diploma or equivalent required. College-level coursework in insurance, business administration, human resources, risk management, or a related field preferred.
- Bachelor’s degree preferred

EXPERIENCE:

- Minimum of five (5) years of experience administering and/or adjusting workers’ compensation claims with a bachelor’s degree, or seven (7) years of relevant experience without a bachelor’s degree.

EXEPECTED NUMBER OF DIRECT REPORTS: 0

KNOWLEDGE, SKILLS, ABILITIES:

- Knowledge of workers’ compensation laws and guidelines, at federal and state level.
- Knowledge of interviewing and investigating procedures.
- Knowledge of legal and medical terminology.
- Knowledge of insurance claims adjusting.
- Experience implementing corporate level programs at the site level, assisting in customization of policies and procedures as necessary to coincide with site operations.
- Ability to interpret and apply directives, guidelines, and laws to workers’ compensation claims.
- Working knowledge of computer applications, including Word, Excel, and PowerPoint.
- Ability to concentrate for long periods of time.
- Ability to exercise great confidentiality.
- Ability to analyze claim data and prepare statistical analysis of claims.
- Ability to communicate effectively.
- Ability to obtain and maintain a criminal record/fingerprint clearance from the Department of Justice and Federal Bureau of Investigation per Easterseals Southern California and/or program requirements.
- Must pass all drug testing required by ESSC.

PHYSICAL REQUIREMENTS IN ACCORDANCE WITH ADA:

- Carrying/Lifting:

Occasional; up to 10 pounds.

- Standing:

Occasional / Up to 3 hours per day.

- Sitting:

Constant / Up to 8 hours per day.

- Walking:

Occasional / Up to 3 hours per day.

- Travel :

Up to 20% of time.

- Repetitive Motion/Activity:

Keyboard activity, telephone use, writing.

- Visual Acuity:

Ability to view computer monitors and read newsprint.

- Environmental Exposure:

None.