Claims Coordinator

Los Angeles Unified School District

19d

About The Position

The Claims Coordinator manages, coordinates, and oversees the claims processing and claims management activities of a workers’ compensation, disability management (return to work or reasonable accommodation), or liability unit in the Division of Risk Management and Insurance Services; recommends and administers policies and procedures; oversees the processing of requests for reasonable accommodation or return to work, claims for payment of workers’ compensation or liability benefits; and coordinates activities with the third party administrator and other District departments.

The Claims Coordinator receives general direction from the Director of Insurance or the Director of Integrated Disability Management.

Requirements

• Graduation from a recognized college or university with a bachelor’s degree, preferably with a major in risk management, business administration, public administration, vocational rehabilitation, or a related field. Qualifying experience beyond that required in a professional level staff position may be substituted for the required education on a year-for-year basis.
• Three years of experience, preferably with a public agency, in any combination of the following areas: Developing, implementing, or coordinating a workers’ compensation program with responsibility for more than 1000 workers’ compensation claims per year, which must include at least one year of experience performing duties regarding workers’ compensation covered by California law.
• Developing, implementing, or coordinating a liability program with responsibility for more than 500 liability claims per year, which must include at least one year of experience performing duties regarding liability claims covered by California law.
• Developing, implementing, or coordinating a return to work or reasonable accommodation program with responsibility for more than 100 cases per year, which must include at least one year of experience performing duties regarding return to work or reasonable accommodations covered by California Law.
• A valid driver’s license to legally operate a motor vehicle in the State of California and the use of a motor vehicle, or the ability to utilize an alternative method of transportation.

Nice To Haves

• Possession of certification as an Associate of Risk Management (ARM), Associate in Risk Management- Public Entities (ARM-P), Associate in Claims (AIC), State of California Self Insured Administrator Certificate, and/or Certified Professional in Disability Management (CPDM) is preferable.
• The ideal candidate for Claims Coordinator will bring a strong background in the application of California workers’ compensation law, including experience supporting return-to-work and reasonable accommodation processes and navigating claims administration within a large-scale, public-sector organization with multiple union bargaining units.
• The ideal candidate will have prior experience overseeing or supporting workers’ compensation programs or complex claims operations, including providing leadership or guidance to staff, coordinating with third-party administrators, medical providers, and legal counsel, and participating in legal proceedings such as depositions or hearings. Experience evaluating the financial and operational impact of claim strategies, reserves, or settlement decisions is highly desirable.
• In addition, the ideal candidate will have demonstrated experience conducting research and investigative work related to disability or employee claims, analyzing complex issues, and developing recommendations that balance legal compliance, operational needs, and employee considerations. This work typically involves close collaboration with internal and external stakeholders such as human resources, safety, employee relations, unions, school administrators, work site managers, claims examiners, outside counsel, and vendors to support effective claim resolution.
• Further, the ideal candidate will bring a strong customer service orientation and proven ability to communicate with a wide range of stakeholders, address concerns professionally, and proactively mitigate potential conflicts throughout the claims process.
• Finally, the ideal candidate will possess strong oral and written communication skills, with the ability to clearly articulate complex workers’ compensation–related concepts, recommendations, and programmatic considerations on behalf of LAUSD and its staff.

Responsibilities

• Plans, organizes, and supervises the day-to-day activities and oversees the performance ofemployees in a unit within the Division of Risk Management and Insurance Services.
• Coordinates and audits Third Party Administrator’s (TPA) files, practices, and claimsadministration; and assists in maintaining on-going oversight.
• Oversees the coordination and communication of information related to employee, student or third party injury incidents, accident prevention, reasonable accommodation, and return to work efforts and remedial measures with District offices, TPA, and other agencies.
• Coordinates and assists the Office of the Inspector General (OIG) and notifies OIG of investigative needs.
• Develops and implements District-wide workers’ compensation, disability management, and liability management training programs.
• Establishes criteria used in the evaluation and settlement of workers’ compensation and liabilityclaims, and oversees implementation to ensure best practice guidelines are met.
• Reviews and evaluates claims processing and payment activity, and reports, settlementauthorization requests; and recommends the settlement of claims within defined levels.
• Provides technical support for administrators, employees, and employee organizationrepresentatives regarding workers’ compensation, disability management, liability and District policies, procedures, and programs.

Benefits

• District paid premiums for your choice of several medical, dental, and vision for you and your dependents; and life insurance plans.
• Membership in the California Public Employee Retirement System (CalPERS).
• Vacation: 24 days each year.
• Paid Holidays: Up to 13 days.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees