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Victim Claims Specialist II (#RO6022)
$23.01-$27.97 Hourly / $3,988.83-$4,848.45 Monthly / $47,866.03-$58,181.46 Yearly




DEFINITION

Under general supervision, performs technical eligibility determination and claim processing duties in the County Victim/Witness Assistance Program; and does related and or other work as required in accordance with Rule 3, Section 3, of the Civil Service Rules.

CLASS CHARACTERISTICS

This is the journey-level class in the Victim Claims Specialist series. Incumbents support the criminal justice activities of the District Attorney’s Office by reviewing Program applications, establishing victim eligibility, processing victim expense claims and approving or denying applications and claims based on the guidelines set forth by the California State Board of Control. Claims may involve victims in San Joaquin County, or may have been submitted by a number of other California counties who contract with San Joaquin County for claims processing. At this level, incumbents work under general supervision and have the delegated authority to independently accept or reject a claim for payment.

This class can be distinguished from the Victim Claims Specialist III because the latter is an advanced journey level class. At that level, an incumbent functions as a lead worker who is responsible for training and auditing the work of a Victim Claims Specialist I, performing audits of finalized claims, and/or assessing/assigning work to other staff. An incumbent at that level may also be assigned advanced reporting responsibilities and/or may complete special research projects.

TYPICAL DUTIES

  • Reviews and evaluates victim-of-crime applications for adherence to California State statutory and eligibility requirements; obtains and analyzes crime reports and other documents from the appropriate law enforcement agency to verify factual case information; contacts law enforcement officers, court officials, attorneys, and others to obtain pertinent information in order to determine initial and on-going Program eligibility; establishes appropriate computer records for applicants based on approval or denial of victim application.
  • Reviews and processes a variety of claims submitted by victims including medical bills, mental health bills, funeral/burial bills, wage loss requests and other expenses; researches information as required to establish a link to the qualifying crime and to verify losses claimed by the victim; calculates losses to victims and determines reimbursements considering all other sources of compensation available; approves or denies claim reimbursement and level of services; notifies victims of claim determinations.
  • Interacts effectively with victims, families, law enforcement personnel and others; obtains accurate information and identifies potential problem issues; acts as a liaison between victims, families and other organizations/individuals regarding Program benefits; interacts with other counties in order to fulfill contract obligations for claims processing.
  • Keeps accurate logs of all claims submitted; creates detailed computer files on all claims processed, whether approved or denied; processes approved bills for payment; creates pre-authorization statements as appropriate.
  • Monitors caseload data and develops comprehensive, periodic summary reports as required to receive State credit; prepares various memorandums and correspondence.
  • Coordinates victim claim services with the Victim/Witness Advocates; refers victims to other agencies as appropriate.

MINIMUM QUALIFICATIONS

Experience:  One year performing claims review and/or program eligibility determination at a level comparable to or higher than Victim Claims Specialist I in San Joaquin County.

Note:  Individuals employed in the San Joaquin County classes of Victim Claims Technician I or Victim Claims Technician II at the time of adoption of this class specification by the Civil Service Commission will be credited with their experience on a year-for-year basis.

Special Requirement:  Successful completion of the State of California Victims of Crime Introductory/Basic Training Course.

License:  Possession of a valid California driver’s license.

KNOWLEDGE

Standard office procedures including the use of computers and other technological equipment; basic mathematics; basic reading and writing skills; technical research methods as they apply to evaluating and processing financial claims; principles of interviewing and gathering information; fundamental aspects of human behavior; basic medical and legal terminology.

ABILITY

Follow oral and written directions; read, understand, and apply regulations and other job related materials; maintain records and prepare reports; deal tactfully with the public; interview, gather, record and evaluate information; establish effective working relationships with a wide variety of people.

PHYSICAL/MENTAL REQUIREMENTS

Mobility-Frequent keyboard operation, sitting; occasional pushing, pulling, bending, squatting; Lifting-Frequent lifting up to 5 pounds; Vision-Constant reading and close-up work requiring good overall vision; frequent eye/hand coordination; occasional color/depth perception and peripheral vision; Dexterity-Frequent holding, gripping, writing and repetitive motion; occasional reaching; Hearing/Talking-Constant hearing normal speech, hearing/talking in person and on the telephone; occasional hearing faint sounds; Emotional/Special Conditions-Frequent public contact, decision making, and concentration; frequent exposure to trauma, grief and death; occasional working overtime.

San Joaquin County complies with the Americans with Disabilities Act (ADA) and, upon request, will consider reasonable accommodations to enable individuals with disabilities to perform essential job functions.


CLASS: RO6022; EST: 1/24/2001;