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Workers Compensation Specialist

One of Public Risk Innovation, Solutions, and Management’s (PRISM) greatest assets is its staff. PRISM employees are smart, creative, hard-working, and passionate individuals working in areas ranging from loss prevention, claims administration, information technology, accounting, and risk pool administration. Working here requires energy, commitment, and teamwork. At the same time, we offer a great work environment built upon our Core Values of People, Families, Trust, Integrity, and Growth. We are looking for an individual who shares these values to join the PRISM team.

About Public Risk Innovation, Solutions, and Management
PRISM (previously CSAC Excess Insurance Authority) is a joint powers authority of California public entities, which was established in 1979 to provide insurance and risk management services to California’s counties. Since then, our membership has expanded beyond the counties to include numerous other public agencies such as cities, schools, joint powers authorities, fire districts, etc. PRISM operates various risk-sharing pools, which provide insurance and risk management services to its members for lines of business including workers’ compensation, general liability, property, medical malpractice, and employee benefits.

About the Position
The Workers’ Compensation Claims Specialist, under the general direction of the Workers’ Compensation Supervising Senior, will:
• Maintain a caseload of future medical excess workers’ compensation claims;
• Monitor reserves and case statuses to ensure compliance with Addendum A Standards;
• Input claims reserves into financial database;
• Report cases with potential above PRISM coverage to requisite carriers;
• Reconcile claims for reimbursement, and present to Claims Review Committee for approval;
• Update information concerning claims activity and maintain claims files;
• Prepare correspondence;
• Generate requisite reports from claims files;
• Contact member agencies or TPAs concerning claims status and information;
• Identify files for closure and do related work as required;
• Attend file reviews with the member and TPA when indicated;
• Provide training to the members and TPAs when indicated.

Desirable Qualifications
The ideal candidate will have an Associates’ Degree and two years of increasingly responsible work experience in insurance claims adjusting, reporting, management and settlement work; or, an equivalent combination of education and experience sufficient to successfully perform the essential functions of the job.
Skills include:
• Strong working knowledge in Microsoft Office including Word and Excel
• Experience working with a RMIS system (SIMS, Valley Oaks, David Systems, ATS, etc.)
• Basic knowledge of recordkeeping principles
• Ability to set priorities and handle multiple projects simultaneously
• Ability to handle basic arithmetical calculations
• Ability to establish and maintain effective working relationships and good public relations with other employees, agencies, members, and the public
• Completion of specialized educational training and courses related to insurance claims adjusting, reporting, settlement, and management are highly desirable
• Public agency claims experience is highly desirable
• SIP Certificate
• Ability to maintain a current workload (diary, mail, settlement authorizations, etc.)
• Ability to travel when indicated

Physical Requirements
Physical requirements of this position typically include: reaching, grasping, talking, hearing, seeing, repetitive motions, exerting up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently, and/or negligible amount of force constantly to move.

PRISM strives to compensate its employees within very competitive salary ranges. The hiring salary range for this position is $4,894 - $5,873 per month. Salary adjustments are based on individual merit and accomplishments. A generous benefit package is provided including Public Employees Retirement System (PERS); a Section 125 Cafeteria Plan with coverage options including health, dental and vision; long-term disability and short-term disability insurance; life insurance; optional deferred compensation program; and sick and vacation leaves. As a PERS participant, PRISM employees are exempt from paying Social Security except for the Medicare portion of the cost.

Application Procedure
Please visit our website at to obtain an application. This position will remain open until filled.

Final Filing Date: 
Saturday, October 31, 2020 - 5:00pm
PRISM (Public Risk Innovation, Solutions, and Management)