Victim Claims Specialist III (#RO6023)
$25.13-$30.54 Hourly / $4,355.08-$5,293.63 Monthly / $52,261.02-$63,523.60 Yearly

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

This is the advanced journey-level class in the Victim Claims Specialist series. Incumbents support the criminal justice activities of the District Attorney’s Office by utilizing advanced skills to review Program applications, establish victim eligibility, process victim expense claims and approve or deny 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, an incumbent functions as a lead worker, working under general supervision to process victim applications and claims as well as train staff, assign work and perform internal claim audits for quality control purposes.

This class can be distinguished from the Victim Claims Specialist II because the latter is the journey level class where incumbents are not expected to have lead responsibilities such as training staff or assigning/auditing claims.

• 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. 
• Acts as a lead worker as assigned; identifies staff training needs and learning opportunities; develops and oversees training plans; assesses and assigns work to staff as appropriate; may provide input to supervisory staff regarding staff assignments and performance; audits staff work for quality control and training purposes; may be assigned to complete special reports or projects. 
• 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.

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

Note:  Individuals employed in the San Joaquin County classes of 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.

Principles and practices of leadership and training; standard office procedures including the use of computers and other technological equipment; mathematics, 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.

Lead, train and audit the work of others; 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.

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.