Workers' Compensation Claims Assistant

Tristar Insurance; Rancho Cordova (CA); On-site; USD 63,039,000 - 68,770,000; Full time

Benefits offered by this job

Medical, Dental, Vision Insurance

Life and Disability Insurance

401(k) Plan

Paid Holidays

Paid Time Off

Referral bonus

Job summary

Tristar Insurance in Sacramento - Rancho Cordova, CA is seeking an entry-level clerical assistant to support workers’ compensation claims under close supervision. This role focuses on data entry, notice preparation, and coordination across the claims team.

You will handle documentation, client communications, and basic clerical duties, including filing, scheduling, and receptionist tasks as needed. The position is full-time with a daytime shift.

Qualifications

• High school diploma or GED required; six months experience in workers’ compensation claims preferred.
• College degree preferred; relevant familiarity with clerical tasks is a plus.
• Proficient in Word and basic office software; strong written and verbal communication.

Responsibilities

• Prepares benefit notices, schedules, and processes benefits and payments on claim files.
• Documents all claim activity in the electronic file and keeps records up to date.
• Prepares and prints letters, notices, and labels; supports clerical workflows.
• Filing, faxing, sorting, and alphabetizing; supports team with general tasks.
• Communicates claim information to clients, counsel, medical providers, and staff.
• Answers phones, takes messages, and provides receptionist support as needed.
• Performs back-up receptionist duties and handles other duties as assigned.

Skills

Keyboarding 45 wpm

Word proficiency

Medical/legal terminology

Alphabetizing & filing

Education

High school diploma or GED

College degree preferred

Job description

Job Details

Level: Entry
Job Location: Sacramento - Rancho Cordova, CA 95670
Position Type: Full Time
Salary Range: $22.00 - $24.00 Hourly
Job Shift: Day
Job Category: Insurance

POSITION SUMMARY

Under close supervision, performs clerical and data entry tasks that assist in the administration of workers’ compensation claims.

DUTIES AND RESPONSIBILITIES

• Prepares benefit notices, schedules, and processes benefit and medical payments on claim files as directed by the Claims Examiner.*


• Documents all work product and claim activity in the electronic claim file.*


• Prepares and prints letters, benefit notices and labels.*


• Provides clerical support, including filing, faxing, sorting, and alphabetizing.*


• Communicates pertinent claim information to the client, legal counsel and medical providers, and internal claims staff.*


• Answers phone calls, takes messages, and responds appropriately.*


• Performs receptionist duties on a back-up basis.


• Other duties as assigned.

*Essential job function.

EQUIPMENT OPERATED/USED

Computer, telephone, 10-key, fax machine, printers, and other basic office equipment.

QUALIFICATIONS REQUIRED

Education/Experience: College Degree preferred; however, High school diploma or GED required, and six (6) months of experience in the workers’ compensation claims industry (preferred).

Knowledge, Skills and Abilities:

• Proficient keyboarding skills (type 45 wpm).


• Working knowledge of medical/legal terminology.


• Ability to alphabetize and collate.


• Proficient in Word.


• Ability to follow written and spoken instructions from several individuals.


• Ability to produce accurate and detailed work.


• Excellent verbal and written communication skills.


• Courteous telephone skills.


• Ability to effectively prioritize multiple projects and due dates.


• Ability to work independently, as well as in cooperation with workgroup.

Other Qualifications: None

BENEFITS

• Medical, Dental, Vision Insurance.


• Life and Disability Insurance.


• 401(k) Plan


• Paid Holidays


• Paid Time Off.


• Referral bonus.

Mental and Physical Requirements

Here are some of the benefits you can enjoy in this role:

Mental and Physical Requirements: [see separate attachment for a copy of checklist of mental and physical requirements]

MENTAL AND PHYSICAL REQUIREMENTS

1. MENTAL EFFORT

a. Reasoning development:

Follow one- or two-step instructions; routine, repetitive task.

Carry out detailed but uninvolved written or verbal instructions; deal with a few concrete
variables.

Follow written, verbal, or diagrammatic instructions; several concrete variables.

X Solve practical problems; variety of variables with limited standardization; interpret instructions.

Logical or scientific thinking to solve problems; several abstract and concrete variables.

Wide range of intellectual and practical problems; comprehend most obscure concepts.

b. Mathematical development:

Simple additional and subtraction; copying figures, counting, and recording.

Add, subtract, multiply, and divide whole numbers.

X Arithmetic calculations involving fractions, decimals, and percentages.

Arithmetic, algebraic, and geometric calculations.

Advanced mathematical and statistical techniques such as calculus, factor analysis, and probability determination.

Highly complex mathematical and statistical techniques such as calculus, factor analysis, and probability determination; requires theoretical application.

c. Language development:

Ability to understand and follow verbal or demonstrated instructions; write identifying information; request supplies verbally or in writing.

Ability to file, post, and mail materials; copy data from one record to another; interview to obtain basic information such as age, occupation, and number of children; guide people and provide basic direction.

X Ability to transcribe dictation; make appointments and process mail; write form letters or routine correspondence; interpret written work instructions; interview job applicants.

Ability to compose original correspondence, follow technical manuals, and have increased contact with people.

Ability to report, write, or edit articles for publication; prepare deeds, contracts or leases, prepare and deliver lectures; interview, counsel, or advise people; evaluate technical data.

2. PHYSICAL EFFORT

a. Physical activity required to perform the job:

Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

X Light work:

a. Exerting up to 20 pounds of force occasionally
b. Exerting up to 10 pounds frequently
c. Exerting a negligible amount of force constantly to move objects

(If the use of arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most of the time, the job is rated for Light Work).

Medium work:

a. Exerting up to 50 pounds of force occasionally
b. Exerting up to 20 pounds of force frequently
c. Exerting up to 10 pounds of force constantly to move objects

Heavy work:

a. Exerting up to 100 pounds of force occasionally
b. Exerting up to 50 pounds of force frequently
c. Exerting up to 20 pounds of force constantly to move objects

Very heavy work:

a. Exerting in excess of 100 pounds of force occasionally
b. Exerting in excess of 50 pounds of force constantly to move objects
c. Exerting in excess of 20 pounds of force constantly to move objects

Visual requirements necessary to perform the job:

Far vision: clarity of vision at 20 feet or more
X Near vision: clarity of vision at 20 inches or less
X Mid-range vision: clarity of vision at distances of more than 20 inches and less than 20 feet
Depth perception: the ability to judge distance and space relationships, so as to see objects where and as they actually are
Color vision: ability to identify and distinguish colors
Field of vision: ability to observe an area up or down or to the right or left while eyes are fixed on a given point

2. PHYSICAL EFFORT (cont.)

Frequency

c. Physical activity necessary to perform the job and frequency (e.g., continually, frequently, or occasionally):

Climbing: Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like, using feet and legs, and/or hands and arms. Body agility is emphasized. This factor is important if the amount and kind of climbing required exceeds that required for ordinary locomotion.

Balancing: Maintaining body equilibrium to prevent falling when walking, standing, or crouching on narrow, slippery, or erratically moving surfaces. This factor is important if the amount and kind of balancing exceeds that needed for ordinary locomotion and maintenance of body equilibrium.

X Stooping: Bending body downward and forward by bending spine at the waist. This factor is important if it occurs to a considerable degree and requires full use of the lower extremities and back muscles.

X Kneeling: Bending legs at knee to come to a rest on knee or knees.

X Crouching: Bending the body downward and forward by bending legs and spine.

Crawling: Moving about on hands and knees or hands and feet.

X Reaching: Extending hand(s) and arm(s) in any direction.

X Standing: Particularly for sustained periods of time.

X Walking: Moving about on foot to accomplish tasks, particularly for long distances.

X Pushing: Using upper extremities top press against something with steady force in order to thrust forward, downward, or outward.

X Pulling: Using upper extremities to extent force in order to drag, haul, or tug objects in a sustained motion.

Foot Motion: Using feet to push pedals.

X Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position to position. This factor is important if it occurs to a considerable degree and requires substantial use of the upper extremities and back muscles.

X Fingering: Picking, pinching, typing, or otherwise working with fingers rather than with the whole hand or arm as in handling.

X Grasping: Applying pressure to an object with the fingers and palm.

Occasionally

X Talking: Expressing or exchanging ideas by means of the spoken word. Those activities in which workers must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.

X Hearing: Perceiving the nature of sounds with or without correction. Ability to receive detailed information through verbal communication, and to make fine discriminations in sound, such as when making find adjustments on machined parts.

Feeling: Perceiving attributes of objects, such as size, shape, temperature, or texture by touching with skin, particularly that of fingertips.

X Repetitive Substantial movements (motions) of the wrists, hands,
Motion: and/or fingers.

Appropriately frequent markers omitted for brevity...)

3. WORKING CONDITIONS

Disagreeable job conditions to which the employee may be exposed and the frequency (e.g., continually, frequently, or occasionally) of this exposure.

WORKING CONDITION
ENVIRONMENTAL
FACTOR
NATURE/REASON
OF EXPOSURE
FREQUENCY

Dirt/Dust
Noise
Temperature extremes
Dampness
Vibrations
Equipment movement hazard
Chemicals/solvents
Electrical shock
Significant work pace/pressure
Odors/Fumes
Other (specify):

Signs:

This job description has been approved by all levels of management:

Human Resources: ___________________

The employee's signature below constitutes the employee's understanding of the mental and physical requirements, essential functions, and duties of the position.

Employee____________________________ Date____________________

Signatures

This job description has been approved by all levels of management:

Human Resources: ___________________

The employee's signature below constitutes the employee's understanding of the mental and physical requirements, essential functions, and duties of the position.

Employee____________________________ Date____________________