Sr Claims Examiner (PH)
About The Position
At The Disneyland Resort, you'll help inspire that magic by enabling our teams to push the limits of Risk Management and create the magic of handling claims and supporting the various Risk Management functions the Disney way! As part of the Risk Management Services team, a Workers' Compensation Examiner, in collaboration with all the resources available, ensures access to any and all benefits necessary to cure or relieve the effects of an occupational injury or illness. The Workers' Compensation Examiner administers these benefits as required by the California Labor Code. Effectively works with the injured Cast Member and provider to facilitate the Cast Member's recovery while mitigating risk. This is a highly dynamic and collaborative role that requires outstanding customer service and communication skills with an understanding of the importance of brand management.
Requirements
- Minimum of 5 years' experience in administering occupational claims in California
- California Self-Insurance Plans Administrator Certification
- Proficient understanding of the key elements of the California Labor Code
- Strong analytical skills in evaluating liability and setting of appropriate reserves and plans of action
- Provides detailed evaluation and permanent disability rating skills
- Utilizes excellent time management skills demonstrated by the ability to prioritize multiple issues and ensure timely completion of work in accordance with department expectations and objectives.
- Proficient and appropriate use of automated claims management systems, paperless document management systems, and multiple web access portals.
- Showcases effective skills in listening, verbal and written communication skills.
- Demonstrates effective collaborative work within multifaceted teams.
- Maintains frequent contact with multiple stakeholders including the injured Cast Member, area management, department management, medical providers, attorneys and other professionals involved in the administration of the claims.
- Professional, courteous and positive demeanor while working with multiple stakeholders.
- Requires ability to work effectively within established levels of authority, seeking out supervision as needed or required by internal procedures and guidelines.
Nice To Haves
- Preferred Certifications such as IEA, WCCP, CPDM
- Bilingual - English/Spanish preferred
- Bachelor's degree
Responsibilities
- Administer Worker's Compensation benefits to injured Cast Members to include investigation, review/analysis of medical reports, arranging medical exams, and rate permanent disability.
- Effectively communicates with Cast Members, physicians, attorneys and other providers.
- Appropriately establish case reserves according to California Self- Insurance Plans and department guidelines.
- Drives and coordinates proactive litigation efforts for expeditious resolution which includes setting cases for hearing, identifying issues and proceeding with appropriate defenses, and partnering with in-house Hearing Representatives or outside defense counsel.
- Oversee the provision of Vocational Rehabilitation benefits with a focus on returning Cast Members to gainful employment.
- Actively pursue final resolution of claims via settlement, venue selection, executing all pertinent documents, and obtaining WCAB approval.
Benefits
- A bonus and/or long-term incentive units may be provided as part of the compensation package, in addition to the full range of medical, financial, and/or other benefits, dependent on the level and position offered.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
