Workers' Compensation Compliance Auditor

Job Description and Duties

Under the general direction of a Supervising Workers' Compensation Compliance Officer within the DWC Audit and Enforcement Unit of the Division of Workers' Compensation, The Workers' Compensation Compliance Officer performs workers' compensation claim file audits on insurance companies, self-insured employers, and third-party administrators to ensure that they have met their obligations under the Labor Code and the California Code of Regulations.

This posting may be used to fill future vacancies in accordance with 2 CCR §249.3

To be considered for this Workers Compensation Compliance Officer job opportunity, applicants must be either reachable on an employment list, have transfer eligibility or have reinstatement eligibility. To take the exam and gain employment list eligibility, please click here to access the exam bulletin:

You will find additional information about the job in the .

Working Conditions

This is a field position. The employee are required to perform their duties remotely and on-site at audit locations. The duties of this job are performed indoors most of the time. Travel by air and vehicle with some overnight travel required. The employee works in the Audit Unit of the Division of Workers' Compensation. The employee’s home office is a laptop, printer, and standard office equipment. Attend meetings in designated conference rooms and be willing to travel for off-site meetings.

This position is located at: DWC Audit Unit, 160 Promenade Circle Suite 340, Sacramento, CA 95834

Special Requirements

The incumbent must demonstrate the ability to establish and maintain cooperative working relationships with staff at all levels both within and outside of DIR to complete work assignments related to overseeing and completing claim file audits. The incumbent must exercise the ability to independently make decisions and perform actions having broad implications on various aspects of DWC Audit Unit processes. The incumbent must demonstrate the ability to lead and facilitate work groups to accomplish goals. In addition, the incumbent must demonstrate the ability to use Internet, email, desktop applications and presentation software to complete assignments. The incumbent must also exercise knowledge to apply the California Code of Regulations and the Labor Code to claim file audits and use analytical and problem-solving skills.

Desirable Qualifications

In addition to evaluating each candidate's relative ability, as demonstrated by quality and breadth of experience, the following factors will provide the basis for competitively evaluating each candidate:

• Knowledge of California workers’ compensation laws and procedures consistent with statute, Title VIII, California Code of Regulations, and relevant case law. Understand claims administration from reporting of injuries to the provision of indemnity benefits and benefit notices; managing medical and medical-legal expenses; settlement and closing of claims. Knowledge of basic arithmetic (i.e., addition, subtraction, multiplication, division, decimals, percentages, and fractions) to determine the Average Weekly Wage, score, and penalty calculations.

• Strong analytical skills to read and comprehend written materials (e.g., references, memos, letters, notes) to apply information and determine appropriate courses of action.
• Proficiency with Microsoft Suite, primarily Word, Excel and PowerPoint applications.
• Strong writing skills for preparing audit reports and strong verbal communication skills for engaging with audit subjects and other stakeholders.
• Work effectively in a team setting to ensure assignments and activities of a team are completed within established timelines, and work cooperatively and productively as a member of a team to achieve a common goal.
• Work independently on projects or assignments without close supervision or detailed instructions to achieve intended results.
• Public speaking -conduct workshop presentations with claims administrators.
• Take a lead role on audits and work multiple projects and/or assignments simultaneously.
• Detail oriented-analyzing and evaluating situations to determine appropriate course of action.
• Interpret and analyze numerical data accurately.
• Flexibility with work environment, from telecommunicating to working at different locations.
• Comfortable with overnight travel.

Benefits

Benefit information can be found on the CalHR website and the CalPERS website.

• Alternate/Modified Work Schedule

• 401(k), 457 and Roth IRA Plans

• Retirement (CalPERS)

• Employee Assistance Program (EAP)

• Medical and Dependent Care Reimbursement Accounts

• Pre-Tax Parking Program

Additional Information

Preference will be given to persons with State Restriction of Appointments (SROA) or Surplus status. Applicants must attach a copy of their most recently dated letter that specifies their designation as either SROA or surplus candidate as proof.

Qualified candidates must have eligibility in State employment, be in a reachable rank on an employment list for this classification, be currently in this classification, or have transfer eligibility to this classification.

If you do not hear from us in 4-6 weeks, you may assume the position has been filled by another applicant. Please note that all additional vacancies that become available may be added to this advertisement.

Please note that the Exam and Certification Online System (ECOS) does not allow you to resubmit your application once you withdraw it. If you have any updates to your online application, please contact the Personnel, Recruitment, & Hiring Unit at (800) 564-0771.

Please let us know how you heard about our position by taking this brief survey: DIR Applicant Survey

Required Application Package Documents

The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

• Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
• Resume is optional. It may be included, but is not required.