8165-Worker's Compensation Supervisor I

Job description

CITY AND COUNTY OF SAN FRANCISCO

DEPARTMENT OF HUMAN RESOURCES

JOB CODE TITLE: WORKER'S COMPENSATION SUPERVISOR I

JOB CODE: 8165

DEFINITION

Under general direction, assists with the claims adjusting and processing for the Workers' Compensation Division. Performs complex work in supervising the review, analysis, investigation and disposition of workers' compensation claims and reports. Provides direct claims supervision of confidential complex cases; provides technical training, auditing, and supervising of personnel or qualified rehabilitation representatives; serves as the departmental liaison to client departments regarding activities of the assigned workers' compensation program; works with the City Attorney's office on litigation strategies; and performs other related duties as required.

DISTINGUISHING FEATURES

The 8165 Worker�s Compensation Supervisor I is distinguished from the 8141 Workers� Compensation Adjuster as the former acts as the first-line supervisor to a group of adjusters. It is distinguished from the Worker's Compensation Claims Manager in that the latter is the claims manager responsible for directing the activities of several Claims Processing Units.

SUPERVISION EXERCISED

Supervises a group of employees engaged in claims adjudication.

EXAMPLES OF IMPORTANT AND ESSENTIAL DUTIES

According to Civil Service Commission Rule 109, the duties specified below are representative of the range of duties assigned to this job code/class and are not intended to be an inclusive list.

1. Receives and reviews all incoming workers' compensation claims to determine complexity and assign to appropriate claims adjusting staff.

2. Advises claims adjuster, claims assistants, and support staff on appropriate claims handling techniques.

3. Provides claims supervision of catastrophic cases, death cases, and confidential complex cases.

4. Serves as the liaison for the workers' compensation coordinators of the client departments.

5. Serves as the workers' compensation technical expert to advise staff and client departments on changes and applicability of workers' compensation laws.

6. Audits the work product of claims adjusters to ensure compliance with applicable laws, and departmental best practices.

7. Generates statistical reports and completes analysis of data.

8. Works with the City Attorney's office on litigation strategies for complex claims.

9. Reviews all self-imposed penalties to determine liability and authorizes payment.

10. Authorizes medical treatment for complex medical cases.

11. Reviews the assignment of Medical Legal Evaluators on complex cases.

12. Works collaboratively with the Occupational Nurse Consultant, Nurse Manager, and Nurse Case Managers to review complex claims and establish medical protocols and member panels.

13. Advises the Occupational Nurse Manager and Consultants on issues related to medical clinic operations.

14. Provides ongoing system support to claims staff.

15. Accurately estimates the potential claim costs (reserves) on complex cases.

16. Provides technical assistance to claims adjusters in determining permanent disability award calculations.

17. Directs the claims investigation on complex claims.

18. Reviews and approves negotiated case settlement with injured workers, attorneys, and interested parties based on established authority levels.

19. Provides daily supervision, guidance, coaching, and mentoring to assigned staff.

20. Completes ongoing performance evaluations of all assigned staff.

21. Provides specialized technical training, as needed, to staff.

22. Performs related duties and responsibilities as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge of: State of California Labor Code applicable to Workers' Compensation, industry accepted practices, policies, and procedures for the operation of the workers' compensation program, and medical terminology.

Ability or Skill to: analyze investigative reports and medical documents; accurately calculate complex disability ratings and awards; supervise, review, train, coach, and evaluate the technical work of personnel and contractors; communicate in writing in a clear and concise manner using correct grammar, vocabulary, spelling and sentence structure; conduct effective interviews, and speak in a clear, concise, organized, relevant, and understandable manner; establish and maintain effective working relationships, deal courteously and tactfully, and contact and assist employees, departmental personnel, and representatives from outside

agencies and organizations; and use a computer system and related software.

MINIMUM QUALIFICATIONS

These minimum qualifications establish the education, training, experience, special skills and/or license(s) which are required for employment in the classification. Please note, additional qualifications (i.e., special conditions) may apply to a particular position and will be stated on the exam/job announcement.

1. Four (4) years of verifiable experience adjusting workers' compensation claims; AND

2. Possession of a Self-Insured Administrator's Certificate issued by the State of California, Department of Industrial Relations.

SUPPLEMENTAL INFORMATION

PROMOTIVE LINES

ORIGINATION DATE:

May 28, 1965

AMENDED DATE:

3/10/86; 10/26/98; 2/2/01; 5/11/01; 6/28/23

REASON FOR AMENDMENT:

To accurately reflect the current tasks, knowledge, skills & abilities, and minimum qualifications.

BUSINESS UNIT(S):

COMMN

Standard information

Disaster service work

All City and County of San Francisco employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the City requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker-related training as assigned, and to return to work as ordered in the event of an emergency.

Historic and future compensation