Worker's Compensation Rep (San Francisc, CA /Concord, CA)

Concord, California
14 Oct 2016
21 Oct 2016
Oil and Gas
Contract Type
Full Time

Based in San Francisco, Pacific Gas and Electric Company, a subsidiary of PG&E Corporation (NYSE:PCG), is one of the largest combined natural gas and electric utilities in the United States. And we deliver some of the nation's cleanest energy to our customers in Northern and Central California. For PG&E, "Together, Building a Better California" is not just a slogan. It's the very core of our mission and the scale by which we measure our success. We know that the nearly 16 million people who do business with our company count on our more than 24,000 employees for far more than the delivery of utility services. They, along with every citizen of the state we call home, also expect PG&E to help improve their quality of life, the economic vitality of their communities, and the prospect for a better future fueled by clean, safe, reliable and affordable energy.

Pacific Gas and Electric Company is an Affirmative Action and Equal Employment Opportunity employer that actively pursues and hires a diverse workforce.  All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, sex, age, religion, physical or mental disability status, medical condition, protected veteran status, marital status, pregnancy, sexual orientation, gender, gender identity, gender expression, genetic information or any other factor that is not related to the job.

Department Overview

The Safety Health & Environmental (SHE) Department works with all lines of business to develop and integrate innovative and proactive safety, health and environmental solutions. The department develops company-wide policies and procedures for Safety, Health and Environmental providing subject matter expertise on a variety of disciplines. Safety, Health and Environmental maintains knowledge of, and interprets and determines regulatory compliance with safety, health and environmental regulations, policies, and public and organizational programs.

Position Summary

The Workers' Compensation Representative (WCR) will manage, review and adjust workers' compensation claims in a timely, accurate, and cost effective manner. WCR ensures state mandated benefits are provided to industrially injured workers, as specified by the California Labor Code in a timely, fair, efficient, and cost effective manner.


- BA or equivalent experience desired.
- Minimum of 3 year claims handling experience or equivalent required (workers' compensation related experience preferred).

- Must have WCCP certification or equivalent.
- Must have successfully completed or has the ability to obtain professional certification of California Self-Insurance Administrator within 18 months.
- Must have designation as an Experienced Claims Adjuster, pursuant to California Code of Regulations, Title 10.
- Must comply with continuing education requirements for the Department of Insurance.


- Responsible for time sensitive decisions to meet regulatory mandates. Demonstrates the ability to analyze and resolve issues, set strategies, negotiate settlements. Develops action plans to provide timely WC benefits, resolve issues and settle WC claims. Negotiates settlements with injured workers within the settlement authority extended by management.
- Solicits information from injured workers, work locations, and medical facilities and claim history to determine WC Compensability.
- Coordinate utilization review and medical management to ensure medical treatment is appropriate and authorized as necessary.
- Evaluates the Company liability and establishes reserves based on the ultimate probable cost of the claim and in accordance with the state of California Self Insurance Plans regulations. Performs periodic re-evaluation of reserves to ensure adequate estimates of future liability are in accordance with state guidelines.
- Identifies and handles cases that may involve Return to Work issues, FEHA, FMLA or other HR, Employment related issues, with guidance from legal counsel or the WC Sr. WCR or WC WCS.
- Identifies potential fraud and initiates the investigation process. Manages potential 3rd party liability, and refers as appropriate.
- Facilitates Early Intervention and return to work efforts with field supervisors, medical providers and injured workers. Coordinates offers of modified, alternative or regular work.
- Communicates with internal external clients in a clear, concise manner, to appropriately administer benefits. Ensure all parties understand requirements and strategies. Acts as SME to resolve issues of a WC nature with client groups. May provide consulting services to various company lines of business, with regard to Workers' Compensation in accordance with company policy, regulatory and state mandated requirements.