Major Claims Specialist
Apply NowCompany: State of California
Location: Sacramento, CA 95823
Description:
Major Claims Operations has an opening for a Major Claims Specialist. The successful candidate will be a team builder and leader with proven technical expertise and the ability to work cooperatively, yet independently. This is a unique opportunity to be a member of our enthusiastic and dedicated Major Claims Operations team.
This position can be filled in the following locations: Bakersfield, Eureka, Fresno, Glendale, Oxnard, Pleasanton, Redding, Riverside, Rohnert Park, Sacramento, Salinas, San Diego, San Francisco, Vacaville, or Stockton.
To be successful in this role, the Major Claims Specialist should have the ability to:
Resolve a broad range of sensitive and complex issues related to Major Claims Operations purpose.
Conduct analytical reviews and formulate procedures/policies. Knowledge of the Labor Code, policies, procedure, claims technology and case law and is considered a Subject Matter Expert in one or more areas.
Lead project teams, and represent the operation in strategy round table with the Claims Executive Team
Exercise excellent judgment, independently and in consultation with claims and legal leadership.
Evaluate complex and time critical claims issues/trends that pose a significant adverse financial and reputational risk for the organization while conducting self with utmost professionalism and displaying integrity to do the right thing.
Recommend multi-million dollar reserves, settlements through complex multi-disciplinary claims strategies involving legal, consulting physicians, nurse case managers, and senior claims leadership. Achieve both superior financial results for the organization and superior medical outcomes for the injured employee and their family.
Maintain regular and predictable attendance and/or communication availability during working hours.
Desirable Qualifications:
Recent claims adjusting experience of 3 years
New to state candidates will be hired into the minimum salary of the classification or minimum of the alternate salary range when applicable. Placement to alternate salary range may be based on education or experience identified in your state application.
You will find additional information about the job in the Duty Statement .
Working Conditions
The successful candidate must reside in California upon appointment.
Selected candidate(s) hired may be required to attend in-person Onboarding at our Vacaville office with expenses for attendance paid by State Fund.
Minimum Requirements You will find the Minimum Requirements in the Class Specification.
Position Details Job Code #:
JC-474275
Position #(s):
402-471-9310-XXX
Working Title:
Major Claims Specialist
Classification:
MANAGER I, STATE COMPENSATION INSURANCE FUND $7,359.00 - $9,142.00
# of Positions:
Multiple
Work Location:
United States
Telework:
Telework
Job Type:
Permanent, Full Time
Department Information
State Fund is California's largest provider of workers' compensation insurance. Established in 1914 by the state legislature, we offer diverse and comprehensive products and services that provide a strong and stable option for employers and injured employees with fast, reliable claims service and medical and indemnity benefits.
Our culture centers on our purpose and values. We exist to provide fairly priced workers' compensation insurance, make workplaces safe, and restore injured workers. To fully represent California, we are committed to our employees by embracing and celebrating our diverse workforce and fostering inclusion to make the workplace a dynamic environment for all. We recognize and reward high performance yet value a healthy work/life balance.
Department Website: http://www.statefundca.com
Special Requirements
To be considered, you must provide a fully completed STD 678 application, resume, and statement of qualifications (if applicable) via CalCareers. Resumes submitted in lieu of the STD 678 may not be accepted. Completed STD 678 must include duties performed, start and end dates, and hours worked per week for each position held.
Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list eligibility, are in the process of obtaining list eligibility, have LEAP eligibility, or have SROA and/or Surplus eligibility may be considered.
Application Instructions
Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.
Final Filing Date: 4/28/2025
Who May Apply
Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.
Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process. Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).
How To Apply
Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov. When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:
Address for Mailing Application Packages
You may submit your application and any applicable or required documents to:
State Compensation Insurance Fund
Mailing Address
Attn: JC-474275 VL
PO BOX 659015
Sacramento , CA 95865
Address for Drop-Off Application Packages
You may drop off your application and any applicable or required documents at:
State Compensation Insurance Fund
Talent Acquisition/Staffing
JC-474275 VL
2275 Gateway Oaks Drive
Sacramento , CA 95833
08:00 AM - 05:00 PM
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:
Benefits Benefit information can be found on the CalHR website and the CalPERS website.
State Fund employees are eligible for a number of benefits. Our benefit package includes:
Health Benefits Program (CalPERS)
Retirement (CalPERS)
Employer Health and Consolidated Benefits Contributions
Dental, Vision
401(k) and 457 Deferred Compensation Plans
Employee Assistance Program
Group Legal Services Insurance
Holidays, Vacation/Sick/Other Paid Leave
Flex Elect Reimbursement Program
Wellness and Recognition
Alternate Work Schedules
Transit Pass Program
Tuition Reimbursement
Dependent Scholarship Program
Leadership Training
Mentoring Program
https://www.statefundca.com//Home/StaticIndex?id=https://content.statefundca.com//careers/Index.asp
Contact Information
The Human Resources Contact is available to answer questions regarding the position or application process.
Department Website: http://www.statefundca.com
Human Resources Contact:
Vanessa La
(916) 924-5074
VLa@scif.com
Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.
EEO Contact:
Rosa Gil-Robles
(800) 499-8668
California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.
Background Investigation
Prior to employment with State Compensation Insurance Fund, a background investigation (BI) will be initiated.
Acknowledgement
Electronic applications submitted through your CalCareer Account are highly recommended and will be received/processed faster than other methods of filing.
By applying to this position, you are also acknowledging that you have received the following information:
Equal Opportunity Employer
The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.
This position can be filled in the following locations: Bakersfield, Eureka, Fresno, Glendale, Oxnard, Pleasanton, Redding, Riverside, Rohnert Park, Sacramento, Salinas, San Diego, San Francisco, Vacaville, or Stockton.
To be successful in this role, the Major Claims Specialist should have the ability to:
Resolve a broad range of sensitive and complex issues related to Major Claims Operations purpose.
Conduct analytical reviews and formulate procedures/policies. Knowledge of the Labor Code, policies, procedure, claims technology and case law and is considered a Subject Matter Expert in one or more areas.
Lead project teams, and represent the operation in strategy round table with the Claims Executive Team
Exercise excellent judgment, independently and in consultation with claims and legal leadership.
Evaluate complex and time critical claims issues/trends that pose a significant adverse financial and reputational risk for the organization while conducting self with utmost professionalism and displaying integrity to do the right thing.
Recommend multi-million dollar reserves, settlements through complex multi-disciplinary claims strategies involving legal, consulting physicians, nurse case managers, and senior claims leadership. Achieve both superior financial results for the organization and superior medical outcomes for the injured employee and their family.
Maintain regular and predictable attendance and/or communication availability during working hours.
Desirable Qualifications:
Recent claims adjusting experience of 3 years
New to state candidates will be hired into the minimum salary of the classification or minimum of the alternate salary range when applicable. Placement to alternate salary range may be based on education or experience identified in your state application.
You will find additional information about the job in the Duty Statement .
Working Conditions
The successful candidate must reside in California upon appointment.
Selected candidate(s) hired may be required to attend in-person Onboarding at our Vacaville office with expenses for attendance paid by State Fund.
Minimum Requirements You will find the Minimum Requirements in the Class Specification.
- MANAGER I, STATE COMPENSATION INSURANCE FUND
- Job Application Package Checklist
- Duty Statement
Position Details Job Code #:
JC-474275
Position #(s):
402-471-9310-XXX
Working Title:
Major Claims Specialist
Classification:
MANAGER I, STATE COMPENSATION INSURANCE FUND $7,359.00 - $9,142.00
# of Positions:
Multiple
Work Location:
United States
Telework:
Telework
Job Type:
Permanent, Full Time
Department Information
State Fund is California's largest provider of workers' compensation insurance. Established in 1914 by the state legislature, we offer diverse and comprehensive products and services that provide a strong and stable option for employers and injured employees with fast, reliable claims service and medical and indemnity benefits.
Our culture centers on our purpose and values. We exist to provide fairly priced workers' compensation insurance, make workplaces safe, and restore injured workers. To fully represent California, we are committed to our employees by embracing and celebrating our diverse workforce and fostering inclusion to make the workplace a dynamic environment for all. We recognize and reward high performance yet value a healthy work/life balance.
Department Website: http://www.statefundca.com
Special Requirements
To be considered, you must provide a fully completed STD 678 application, resume, and statement of qualifications (if applicable) via CalCareers. Resumes submitted in lieu of the STD 678 may not be accepted. Completed STD 678 must include duties performed, start and end dates, and hours worked per week for each position held.
Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list eligibility, are in the process of obtaining list eligibility, have LEAP eligibility, or have SROA and/or Surplus eligibility may be considered.
Application Instructions
Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.
Final Filing Date: 4/28/2025
Who May Apply
Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.
Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process. Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).
How To Apply
Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at www.CalCareers.ca.gov. When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:
Address for Mailing Application Packages
You may submit your application and any applicable or required documents to:
State Compensation Insurance Fund
Mailing Address
Attn: JC-474275 VL
PO BOX 659015
Sacramento , CA 95865
Address for Drop-Off Application Packages
You may drop off your application and any applicable or required documents at:
State Compensation Insurance Fund
Talent Acquisition/Staffing
JC-474275 VL
2275 Gateway Oaks Drive
Sacramento , CA 95833
08:00 AM - 05:00 PM
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 www.CalCareers.ca.gov. 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 required and must be included.
Benefits Benefit information can be found on the CalHR website and the CalPERS website.
State Fund employees are eligible for a number of benefits. Our benefit package includes:
Health Benefits Program (CalPERS)
Retirement (CalPERS)
Employer Health and Consolidated Benefits Contributions
Dental, Vision
401(k) and 457 Deferred Compensation Plans
Employee Assistance Program
Group Legal Services Insurance
Holidays, Vacation/Sick/Other Paid Leave
Flex Elect Reimbursement Program
Wellness and Recognition
Alternate Work Schedules
Transit Pass Program
Tuition Reimbursement
Dependent Scholarship Program
Leadership Training
Mentoring Program
https://www.statefundca.com//Home/StaticIndex?id=https://content.statefundca.com//careers/Index.asp
Contact Information
The Human Resources Contact is available to answer questions regarding the position or application process.
Department Website: http://www.statefundca.com
Human Resources Contact:
Vanessa La
(916) 924-5074
VLa@scif.com
Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.
EEO Contact:
Rosa Gil-Robles
(800) 499-8668
California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.
Background Investigation
Prior to employment with State Compensation Insurance Fund, a background investigation (BI) will be initiated.
Acknowledgement
Electronic applications submitted through your CalCareer Account are highly recommended and will be received/processed faster than other methods of filing.
By applying to this position, you are also acknowledging that you have received the following information:
- California State benefits
- Duty statement/Job Description
- Salary ranges and steps for the classification(s) advertised
Equal Opportunity Employer
The State of California is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation.
It is an objective of the State of California to achieve a drug-free work place. Any applicant for state employment will be expected to behave in accordance with this objective because the use of illegal drugs is inconsistent with the law of the State, the rules governing Civil Service, and the special trust placed in public servants.