Claims Assistant - General Liability & Workers

The City of Anaheim is seeking motivated, detail-oriented individuals to join our Risk Management Division as Claims Assistants
. We currently have openings in both the General Liability and Workers’ Compensation units.

• General Liability Unit: 1 full-time position
• Workers’ Compensation Unit: 1 full-time position and 1 part-time position*

* The part-time position usually averages 30 hours per week. A minimum number of hours is not guaranteed.

This role provides administrative support to the General Liability unit in all aspects of claims processing. The ideal candidate is highly organized, excels at time management, and has the aptitude for strong attention to detail. Candidates must possess experience performing highly complex clerical work involving extensive record keeping, interpretation of policies, documents, and a high level of independence when performing assigned duties.

Related public sector experience is desirable but not required.

This role will support the Workers’ Compensation unit with various tasks related to claims administration. The ideal candidate is highly organized, excels at time management, and has the aptitude for strong attention to detail. Candidates must possess experience performing highly complex clerical work involving extensive record keeping, interpretation of policies, documents, and a high level of independence performing duties. Possession of Insurance Education Association certification, coupled with public sector experience is highly desired.

Journey level experience as a Medical Only Adjuster, holding a State of California required designation as a Medical Only Adjuster is also highly desirable.

The following functions are typical for this classification. Incumbents may not perform all of the listed functions and/or may be required to perform additional or different functions from those set forth below to address business needs and changing business practices.

• Set up new claim files by reviewing claims for completeness, check for previous notice of claim, requesting/pulling general accident or vehicle/ police reports and cross referencing with any similar claims.
• Enter claims into the General Liability System and prepare file, abstract summary face sheet, index card and enter on the claim log.
• Investigate and gather pertinent information to assist in the evaluation of claims; request all known existing reports (i.e. general accident, first aid incident, paramedic, vehicle accident and police reports); list in appropriate index files.
• Evaluate and process low value property claims; evaluate for reasonable cost; goes out in field and investigate claim; determine settlement if claim is sufficient and owed; claims resulting from a contractor, identify the appropriate contractor, obtain copies of insurance documents, put contractor on notice and indemnify the city.
• Evaluate damages for reasonable cost using standard depreciation rules, or use an independent appraiser to assist in the evaluation, when damages are paid by the City.
• Prepare and process a wide variety of forms and letters in the completion of assigned duties; act upon claims, lawsuits and interrogatories within designated time frames.
• Assign claim numbers to all claims declared sufficient by the City Attorney's Office (high volume claims) and route to Claims Examiner for rejection, settlement or further investigation.
• May work with and/or assist professional claims staff by performing various aspects of claims investigation and/or data and evidence gathering.
• Perform related duties and responsibilities as required.

• Set up claim files by assigning numbers, verifying information on injury form, setting amount of medical reserves required for injury (based upon past practice not predetermined amounts); reviews with Claims Examiner then enters into computer system using Gen Source.
• Independently manage and process all no lost time claims (either no lost time or up to three (3) days lost time or medical treatment only); lost time claims, verify return to work or modified work status with treating physician.
• Ev…