Los Angeles County Metropolitan Transportation Authority - Los Angeles, CA
posted 2 days ago
Los Angeles, CA
Executive, Legislative, and Other General Government Support
About the position
This position requires the review of incoming bills for processing, medical reports, legal correspondence and handling of Requests for Authorization in a timely manner. In addition, the position will also be responsible for responding to incoming calls, emails, issuing timely benefit payments and the appropriate benefit letters. This position is responsible for preparing files for a file review/roundtable with several other parties within and/or outside of Metro.
Responsibilities
- Conducts senior analyst-level investigations upon receipt of new claims
- Assists employees who have been injured on the job and processes benefits due to injured employees
- Handles issues and problems regarding injured workers who have filed claims
- Processes medical bills and liens accumulated during an injured employee claim process
- Reviews and responds daily to all incoming legal and medical mail on a timely manner in accordance with California Labor Code regulations
- Handles claim files efficiently to ensure all benefits have been paid timely and appropriately
- Provides quality customer service to injured employees, division personnel, and providers
- Maintains claim files on an effective diary system to aggressively handle claims and ensure timely responses
- Works closely with legal to strategize on plans of action for appropriate resolution of claims
- Mentors and trains lower level employees
- Provides a high quantity and quality of work in accordance with departmental policies and procedures and in accordance with the California Labor Code Regulations and Requirements
- Prepares files for presentation to division personnel as required/needed
- Contributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of Metro are carried out
- May be required to perform other related job duties
Requirements
- Bachelor's Degree in Business or a related field
- Three years of relevant experience handling, analyzing, and resolving workers' compensation claims and caseload of varying types of employers, including California workers' compensation laws experience
- A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job-related essential functions
Nice-to-haves
- California Workers' Compensation Claims Administration (WCCA) Certificate preferred
- Prior employer's Designation Certificate preferred
- California Self-Insurers Administration Certificate preferred
- Certifications related to workers' compensation claims handling
- Experience conducting full-cycle workers' compensation claims with varying degrees of severity and regulatory requirements
- Experience handling high-volume workload while adapting to shifting priorities
