Job Title: Senior Workers' Compensation Settlement Specialist
The Senior Workers’ Compensation Claims Settlement Specialist will, under the direction of the Workers’ Compensation Claims Manager, focus their attention on reducing the outstanding liability of the Excess Workers’ Compensation Program by resolving claims via C&R and assisting members with handling complex settlement negotiations. It is anticipated this position will carry a caseload of approximately 125 – 130 claims and will work closely with PRISM Claims Specialists, Defense and Applicant Attorneys and TPA representatives who will retain responsibility for the underlying claim. The Senior Workers’ Compensation Claims Settlement Specialist will proactively pursue settlement within the member agency, PRISM, and reinsurance carrier coverage levels as well as contact and discuss potential defenses and settlement strategies with member agency personnel, legal representatives and claims representatives.
Attendance at settlement conferences, mediations and WCAB hearings is expected. Knowledge of structured settlements and the ability to negotiate are required in this position. A background with creative settlement strategies would be very beneficial. This position will be required to present settlement requests to the Claims Review Committee, Primary Workers’ Compensation Committee and/or Executive Committee for authorization when settlement amounts exceed staff authority levels. The Senior Workers’ Compensation Claims Settlement Specialist will also be required to enter data into the Authority computer system, update current records as necessary, generate requisite reports from the claims system in a paperless environment and attend Board and Committee meetings as required.
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 (SIMS, Origami, Ventiv, etc.)
• Ability and experience with negotiating settlements with the injured worker, applicant attorney and/or other parties involved
• 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
• Ability to calculate life pension benefits
• Knowledge of structured settlements
• Knowledge of applicable California worker’s compensation laws and regulations
• Knowledge of CMS and MSA requirements
• 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 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 50% of travel may be required.
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 salary range for this position is $6,353 to $7,782 per month. Salary is depended on experience and qualifications. A generous benefit package is provided including Public Employees Retirement System (PERS) health benefits, dental, vision, long-term disability, life insurance, PERS retirement, deferred compensation program, sick leave, vacation leave, and section 125 cafeteria benefits. PRISM employees do not pay into Social Security except for the Medicare portion of the cost.
Interested persons must submit a resume and a completed application to the Human Resource Manager at PRISM. Please visit our website at www.prismrisk.gov to obtain an application.
Apply by: Tue, 05/04/2021