Job Description
Title: Jr. WC Adjuster
Classification: Non-Exempt
Reports To: Risk Management Worker’s Compensation Manager
Hourly Payrate: $25.00 - $35.00
The compensation range provided is in compliance with the state specific laws. Factors that may be used to determine your actual rate of pay include your specific skills, years of experience and other factors.
This position is currently located in Sylmar, California, and will relocate to Santa Clarita in the third quarter of 2023. We do not provide remote or hybrid employment.
Job Description
Position Summary:
Provide hands-on team support under general supervision from the Workers’ Compensation Manager in medical and Indemnity Workers’ Compensation claims. Responsible for maintaining and actively managing Worker’s medical and non-litigated Indemnity claims up to successful closure. Responsible for interacting with TPA, monitoring claims with the corresponding adjusters, and reviewing and recommending proposals for WC claim settlements/resolutions (Medical and Indemnity Claims). Responsible for interacting with all internal customers: all stores, warehouses, operations and external customers: all industrial clinics. Be an integral and critical team member supporting administration, implementation, and continuous improvement of the safety of Vallarta’s WC Resolution Program. Actively support the goal of assisting the store in achieving World Class Safety standards.
General Duties and Responsibilities:
- Be responsible for claims intake and reporting process from the beginning to the end of standard operating procedure.
- Answer Risk Management’s Claims Support phone line and respond to general and some specific inquiries concerning Claims matters, including pre-screening potential new claimants arising from stores.
- Follow up with stores to ensure we successfully manage WC or potential WC claims.
- Analyze and manage complex or technically difficult WC medical and indemnity claims by investigating and gathering information to determine the exposure on the claim; successfully manage claims through well-developed action plans to an appropriate and timely resolution up to and including medical care.
- Assesses WC medical and indemnity claims liability and resolves claims.
- Assist WC Risk Management Manager with managing active claims by following up on phone calls, filing forms electronically and by postal mail, managing bills, and document management such as filing, identifying and recommending closing stale cases, and any other areas where an adjuster requires assistance in managing their claims.
- Pro-actively assist with managing Vallarta Supermarkets health and safety programs and resources.
- Pro-actively assist with the training, development and performance improvement of HR/Safety Coordinators as needed or recommended. 05/08/23
- Manage a health and safety management audit process and perform regular assessments and audits of facilities and programs for compliance. OSHA 300 compliance.
- Maintain, update and upgrade safety management performance measurement metrics, and generate timely reports to all levels of management.
- Train new managers and other personnel in their respective safety and safety management roles and responsibilities.
- Respond to all requests for safety management support, resources, material, and guidance.
Knowledge and Skills:
- Bilingual (Spanish) – read, write, speak fluently required.
- Empathetic Listening skills with innate curiosity
- Multi-task and prioritize workload
- Must be highly organized and detail oriented
- Able to work with minimal supervision and accomplish expectations
- Handle sensitive and confidential information appropriately
- Function in a fast-paced environment
- Able to travel as required by business necessity
- Outstanding customer service skills
- Excellent written and verbal communication skills
- Proficient in Microsoft Office
- Exceptional analytical and problem solving skills
- Previous work experience related to customer service, workers compensation or human resources functions.
- Proficiency in MS Office (word, PowerPoint and excel) is required.
- Ability to prioritize and execute multiple tasks and projects at once.
Physical Demand
- Will be required to spend long hours sitting and using office equipment and computers.
- May also have to do some light lifting of supplies and materials from time to time.
- Expressing or exchanging ideas by means of the spoken word to impart oral information to team members and to convey detailed spoken instructions to other team members accurately, clearly, or quickly.
- Manage a number of requests and situations at one time or simultaneously (multitask)
- Heavy phone interaction with all internal and external customers
Position Type/Expected Hours of Work
This is a non-exempt level position; Monday – Friday, 8:00am – 5:00pm (ON-SITE); schedule would be based on business necessity. Must be willing to work; morning, nights, weekends, and holidays based on business necessity and coordinated through the reporting supervisor.
This job description is not intended to be all-inclusive, and employees may perform other duties as directed. All employees are expected to perform any reasonable task or request that is consistent with fulfilling company goals and objectives.