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Senior Claims Examiner - Disneyland

3 Months ago • 5 Years + • Administrative • $85,800 PA - $115,000 PA

Job Summary

Job Description

The Senior Claims Examiner at Disneyland Resort is responsible for administering Workers' Compensation benefits to injured Cast Members. This includes investigating claims, reviewing medical reports, arranging medical exams, and rating permanent disability. The role requires effective communication with Cast Members, physicians, and attorneys, as well as establishing case reserves and coordinating litigation efforts. The ideal candidate will have at least 5 years of experience in administering occupational claims in California, possess a California Self-Insurance Plans Administrator Certification, and demonstrate strong analytical, communication, and time-management skills. They will also oversee Vocational Rehabilitation benefits, actively pursue claim resolution, and maintain frequent contact with various stakeholders.
Must have:
  • 5+ years experience in CA occupational claims
  • CA Self-Insurance Plans Administrator Certification
  • Strong analytical & communication skills
  • Proficient in claims management systems
  • Knowledge of California Labor Code
Good to have:
  • IEA, WCCP, CPDM Certifications
  • Bilingual (English/Spanish)
  • Bachelor's Degree

Job Details

Job Summary:

About the Role & Team

At The Disneyland Resort, you'll help inspire that magic by enabling our teams to push the limits of Risk Management and create the magic of handling claims and supporting the various Risk Management functions the Disney way!

As part of the Risk Management Services team, a Workers' Compensation Examiner, in collaboration with all the resources available, ensures access to any and all benefits necessary to cure or relieve the effects of an occupational injury or illness. The Workers' Compensation Examiner administers these benefits as required by the California Labor Code. Effectively works with the injured Cast Member and provider to facilitate the Cast Member's recovery while mitigating risk. This is a highly dynamic and collaborative role that requires outstanding customer service and communication skills with an understanding of the importance of brand management.

What You Will Do

  • Administer Worker's Compensation benefits to injured Cast Members to include investigation, review/analysis of medical reports, arranging medical exams, and rate permanent disability.
  • Effectively communicates with Cast Members, physicians, attorneys and other providers.
  • Appropriately establish case reserves according to California Self- Insurance Plans and department guidelines.
  • Drives and coordinates proactive litigation efforts for expeditious resolution which includes setting cases for hearing, identifying issues and proceeding with appropriate defenses, and partnering with in-house Hearing Representatives or outside defense counsel.
  • Oversee the provision of Vocational Rehabilitation benefits with a focus on returning Cast Members to gainful employment.
  • Actively pursue final resolution of claims via settlement, venue selection, executing all pertinent documents, and obtaining WCAB approval.

Required Qualifications & Skills

  • Minimum of 5 years' experience in administering occupational claims in California
  • California Self-Insurance Plans Administrator Certification
  • Proficient understanding of the key elements of the California Labor Code
  • Strong analytical skills in evaluating liability and setting of appropriate reserves and plans of action
  • Provides detailed evaluation and permanent disability rating skills
  • Utilizes excellent time management skills demonstrated by the ability to prioritize multiple issues and ensure timely completion of work in accordance with department expectations and objectives.
  • Proficient and appropriate use of automated claims management systems, paperless document management systems, and multiple web access portals.
  • Showcases effective skills in listening, verbal and written communication skills.
  • Demonstrates effective collaborative work within multifaceted teams.
  • Maintains frequent contact with multiple stakeholders including the injured Cast Member, area management, department management, medical providers, attorneys and other professionals involved in the administration of the claims.
  • Professional, courteous and positive demeanor while working with multiple stakeholders.
  • Requires ability to work effectively within established levels of authority, seeking out supervision as needed or required by internal procedures and guidelines.

Preferred Qualifications

  • Preferred Certifications such as IEA, WCCP, CPDM
  • Bilingual - English/Spanish preferred
  • Bachelor's degree

Education

High School Diploma or equivalent


The hiring range for this position in California is $85,800.00 to $115,000.00 per year. The base pay actually offered will take into account internal equity and also may vary depending on the candidate’s geographic region, job-related knowledge, skills, and experience among other factors. A bonus and/or long-term incentive units may be provided as part of the compensation package, in addition to the full range of medical, financial, and/or other benefits, dependent on the level and position offered.

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About The Company

From classic animated features and exhilarating theme park attractions to cutting edge sports coverage, and the hottest shows on television, The Walt Disney Company has been making magic since 1923, creating unforgettable stories that connect with audiences around the world. And we’re just getting started!

The key to our success…. The Cast, Crew, Imagineers and Employees who honor Disney’s rich legacy by stretching the bounds of imagination to create the never-before-seen, bringing unparalleled entertainment experiences to people of all ages. Begin a career that delivers unparalleled creative content and experiences to audiences around the world and just imagine the stories you could be part of…

What is #LifeAtDisney like? It’s a series of magical moments with cast members and employees developing and telling our stories in the most innovative ways. Whether it’s a day spent as a Disney VoluntEAR, or celebrating the release of a new interactive experience, retail product or movie, our days are filled with the knowledge that we are creating entertainment experiences the whole family can enjoy. Follow @DisneyCareers on Facebook, Twitter and Instagram for a peek behind-the-curtain, and discover how you could connect to a world of stories with Disney!

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