Under immediate supervision, learns to perform 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 entry-level class in the Victim Claims Specialist series. Incumbents learn how to 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 close supervision and do not have the authority to independently accept or reject a claim for payment. However, as experience is gained, supervision becomes more general and employees may work with greater independence.
This class can be distinguished from the Victim Claims Specialist II because the latter is a journey level class and incumbents perform the full range of claim processing functions under general supervision.
TYPICAL DUTIES
Learns to review and evaluate victim-of-crime applications for adherence to California State statutory and eligibility requirements; learns to obtain and analyze crime reports and other documents from the appropriate law enforcement agency to verify factual case information; learns to contact law enforcement officers, court officials, attorneys, and others to obtain pertinent information in order to determine initial and on-going Program eligibility; learns to establish appropriate computer records for applicants based on approval or denial of victim application.
Learns to review and process a variety of claims submitted by victims including medical bills, mental health bills, funeral/burial bills, wage loss requests and other expenses; learns to research information as required to establish a link to the qualifying crime and to verify losses claimed by the victim; learns to calculate losses to victims and determine reimbursements considering all other sources of compensation available; learns to recommend approval or denial of reimbursement and level of services; notifies victims of claim determinations.
Learns to interact effectively with victims, families, law enforcement personnel and others; learns to obtain accurate information and identify potential problem issues; learns to act as a liaison between victims, families and other organizations/individuals regarding Program benefits; learns to interact with other counties in order to fulfill contract obligations for claims processing.
Learns to keep accurate logs of all claims submitted; learns to create detailed computer files on all claims processed, whether approved or denied; learns to process approved bills for payment; learns to create pre-authorization statements as appropriate.
Learns to monitor caseload data and develop comprehensive, periodic summary reports as required to receive State credit; prepares various memorandums and correspondence.
Learns to coordinate victim claim services with the Victim/Witness Advocates; learns to refer victims to other agencies as appropriate.
MINIMUM QUALIFICATIONS
Education: Completion of sixty (60) semester units at an accredited college or university, with at least fifteen (15) units in business, social science, computer science, English and/or mathematics.
Substitution: Responsible clerical or technical work experience at a level equivalent to or higher than the San Joaquin County class of Office Assistant III may substitute for the above education on the basis of one year of experience being equal to thirty (30) semester units.
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.