Claims Examiner

Santa Ana Unified School District • Santa Ana, CA

382d

About The Position

Founded in 1888, the Santa Ana Unified School District (SAUSD) is the second largest school district in Orange County serving approximately 36,000 students and the 2nd largest employer in Santa Ana, providing job opportunities to approximately 5,000 employees. SAUSD is comprised of 34 Elementary, 6 Intermediate, 4 Alternative Educational Options, 6 High Schools, 1 dependent charter, 1 child development center, 2 early childhood education programs and 1 Deaf and Hard of Hearing Regional Program K-6. SAUSD is committed to providing each of its students with a high-quality education, rigorous and advanced programs, and a nurturing, safe environment with state-of-the-art facilities, 21st century learning and technology, and a direct pathway to college upon graduation. Our district proudly boasts one of the highest graduation rates in the state of California. SANTA ANA UNIFIED SCHOOL DISTRICT CLAIMS EXAMINER BASIC FUNCTION: Under direction of the Director of Risk Management, receive and administer claims made against the District's self-insurance program, including workers' compensation claims, liability claims and property claims. Direct investigations, pursue subrogation opportunities, calculate and pay benefits, direct attorneys representing the District on litigated claims, pay appropriate amounts to medical providers and vendors, maintain a pro-active settlement program.

Requirements

• Graduation from high school.
• Two years' experience as a claims examiner adjusting lost time and litigated cases.
• Knowledge of workers' compensation law and procedures.
• Knowledge of liability and property law.
• Knowledge of civil litigation procedures.
• Knowledge of medical terminology and procedures as they relate to casualty claims.
• Proficiency in written and oral Spanish as well as English is highly desirable.

Responsibilities

• Determine District's legal obligation to claimant.
• Investigate questionable claims.
• Defend against false and fraudulent claims.
• Calculate and authorize payment of work comp benefits.
• Select and mail appropriate benefit notices.
• Adjust and authorize bills for payment.
• Establish and maintain proper work flow.
• Prepare reports, memos, and letters.
• Identify safety hazards.
• Maintain a file diary.
• Perform related duties as required.

Benefits

• The District provides a nurturing and safe environment.
• State-of-the-art facilities and technology.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Executive, Legislative, and Other General Government Support
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees