Placer County

Claims Specialist - Senior (#12857)

$26.15-$32.66 Hourly / $4,532.67-$5,661.07 Monthly / $54,392.00-$67,932.80 Yearly


DEFINITION

To perform the more difficult or complex work in assisting victims with reimbursement from the state restitution programs to help pay bills and expenses that result from violent crime; to provide information to victims of crime about the criminal justice system; to provide administrative and technical support for program operations; to exercise technical and functional lead supervision over assigned staff; and to function as an integral and supportive member of the Victim/Witness multi-disciplinary team.

DISTINGUISHING CHARACTERISTICS

This is the advanced journey level class in the Claims Specialist series.  Positions at this level are distinguished from other classes within the series by the level of responsibility assumed, complexity of duties assigned, independence of action taken, as well as by the nature of the public contact required.  Employees in this job class perform the most difficult and responsible types of duties assigned to classes within this series.  Employees at this level are required to be fully trained in all procedures related to claims operations as well as aware of victim advocacy programs.

SUPERVISION RECEIVED AND EXERCISED

Receives general supervision from the Victim/Witness Supervisor.

Exercises technical and functional supervision over assigned staff.

EXAMPLES OF ESSENTIAL DUTIES

Duties may include, but are not limited to, the following:
  • Assign, review, coordinate and monitor the work performed by assigned staff to ensure claims are in accordance with regulatory guidelines.
  • Provide technical and function lead supervision to assigned staff.
  • Prepare and process the more complex claims through the State crime compensation database with general oversight from the state restitution program.  
  • Provide claim-processing support to other counties per agreement with the Joint Powers Agreement (JPA) through the state restitution program.
  • Review and evaluate legislation, codes and administrative regulations to ensure program effectiveness and compliance with the requirements.
  • Perform specialized assignments or projects as determined by the needs of the Department.
  • Assist victims in completing victim of crime applications for benefit eligibility purposes; determine which documents will be necessary to support wage and/or medical losses on applications.
  • Complete analysis of financial losses including those from medical expenses and wage losses; consider possible sources of reimbursement, i.e., insurance coverage, civil suit settlements, restitution orders and public assistance programs; obtain verification from medical providers, employers, insurance companies and other agencies.
  • Determine and request necessary verification/data to accurately evaluate and determine applicant’s eligibility for designated programs.
  • Interpret and explain designated program regulations, obligations, procedures and other pertinent information on an individual basis, in person or by telephone, to applicants, participants and subordinate staff.  
  • Maintain appropriate and accurate case records, documentation and files, including performing data entry into automated record systems; monitor and follow-up on due dates; prepare and maintain other documents associated with designated program areas and related reporting requirements.
  • Prepare correspondence, program information and related reports.
  • Travel to and from locations in a variety of outdoor weather conditions.
  • Maintain records and statistics as requested by the Victim/Witness Supervisor.
  • Establish and maintain working relationships with other criminal justice and public and private agencies.
  • Build and maintain positive working relationships with co-workers, other County and departmental employees, community agencies and resources, and the public utilizing principles of effective customer service.
  • Perform related duties as required.

WORKING CONDITIONS

Work is typically performed in an office environment with controlled temperature conditions.

MINIMUM QUALIFICATIONS

Experience and Training
Any combination of experience and training that would provide the required knowledge and abilities is qualifying.  A typical way to obtain the required knowledge and abilities would be:

Experience: Two years of responsible experience performing duties similar to a Claims Specialist II with Placer County.

Training: Equivalent to an associate's degree from an accredited college or university with a major in criminal justice, accounting, public administration, business administration, or a closely related field.

License or Certificate:

  • May need to possess a valid driver's license as required by the position.  Proof of adequate vehicle insurance and medical clearance may also be required.
  • Must obtain certification from the California Victim Compensation Board (Cal VCB) for processing of applicant claims within twelve months of employment.

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge of:

  • Criminal justice system.
  • Regulations and procedures of victim compensation program.
  • Principles and practices of effective leadership including training, motivating, team building and assigning and reviewing work.
  • Financial record keeping practices.
  • English usage, spelling, grammar and punctuation; basic mathematical calculations.
  • Modern office procedures, methods and computer equipment.
  • Interviewing techniques for obtaining factual and financial information.
  • Automated information systems utilized in case management.
  • Modern office procedures, methods and computer hardware/software and its applications.
  • English usage, spelling, grammar and punctuation; basic mathematical calculations. 
Ability to:

  • Train, assess, review and evaluate the work of subordinate staff.
  • Prioritize the work of others in an effective and timely manner.
  • Understand and apply complex laws and regulations in an independent manner, and interpret and explain complex regulations and procedures to less knowledgeable individuals.
  • Counsel and assist victims and witnesses of crime in crisis situations.
  • Deal with hostile and uncooperative victims and witnesses who are under emotional stress.
  • Obtain information through interviews and conversation.
  • Provide appropriate emotional support to traumatized clients.
  • On a continuous basis, know and understand all aspects of the job; intermittently analyze work papers; identify and interpret technical and emotional information; explain program regulations and procedures to victims and the general public.
  • Utilize an automated system to enter/retrieve information and to track/monitor participants through program components.
  • Effectively interview a wide variety of individuals from diverse cultural and socio-economic backgrounds and who may be physically, emotionally, or mentally impaired or distressed.
  • Maintain confidentiality.
  • Work with various cultural and ethnic groups in a tactful and effective manner.
  • Act quickly and calmly in emergency situations.
  • Recognize differences in human behavior resulting from cultural, financial and other forms of deprivation found in client populations.
  • Analyze situations quickly and objectively and determine proper course of action.
  • On a continuous basis, sit at a desk for long periods of time; intermittently walk, stand, bend, climb, squat, twist and reach while retrieving or returning files.  Intermittently twist to reach equipment surrounding desk; perform simple grasping and fine manipulation; use telephone and write or use a keyboard to communicate through written means; see with correctable acuity sufficient to read characters on computer screen; hear and speak with correctable acuity sufficient to communicate with clients; and lift light weight.
  • Communicate clearly and concisely, both orally and in writing.
  • Establish and maintain effective working relationships with those contacted in the performance of required duties.

MISCELLANEOUS INFORMATION

Length of Probation:

  • All permanent appointments from open eligible lists to positions in the classified service shall serve a probationary period of twelve (12) calendar months or two thousand eighty (2,080) hours, whichever is more.

Bargaining Unit:

  • General

CLASS: 12857; EST: 6/1/2004; REV: 7/13/2020;