Job Description

Job Description and Duties

This is a 24-month limited term position which may be extended, cancelled, or made permanent at any time.

If becoming permanent, the selected candidate must be eligible for a permanent appointment at the time of the LT appointment or at the time of the conversion.

This position may be filled at one of the following State Fund locations:   Fresno, Glendale, Pleasanton, Redding, Riverside, Rohnert Park, Santa Ana, or Vacaville . 

The Claims Processing Center - Medical Reimbursement Analysis Unit has an immediate opening for a Medical Reimbursement Adjuster at the Workers' Compensation Claims Adjuster level. This is a unique opportunity for a self-motivated individual with strong analytical and communication skills to support the CPC and Claims staff in determining appropriate fee schedule and reimbursement policies and amounts. Additionally, the position will be a limited-term appointment for 24 months but may become permanent with management approval. Note: Currently this position is a work from home position, which requires fast and reliable internet in order to access State Fund’s network and applications. The position may be transitioned to the office if the internet speed cannot support working from home.

The following is a brief outline of the duties of the Medical Reimbursement Adjuster as envisioned by the management team:

• Respond to fee schedule and workflow related questions submitted to the Bill Review Helpdesk
• Provide ongoing support for the bill review software application to ensure the effectiveness and efficiency of State Fund’s Automated Bill Review programs including Capstone rules programming, testing, and import
• Participate as SME and/or serve as project lead on medical reimbursement related projects and initiatives
• Provide oversight, administration and authorization for exception reimbursement outside applicable fee schedule or business practices

A minimum of 2 years recent Medical Reimbursement policy and/or senior level bill review experience is preferred. Only the most qualified candidates will be considered and interviewed.

You will find additional information about the job in the .

Minimum Requirements

You will find the Minimum Requirements in the Class Specification.

Additional Documents

Special Requirements

To be considered, you must provide a fully completed STD 678 application, resume, and statement of qualifications via CalCareers. Resumes submitted in lieu of the STD 678 may not be accepted. Completed STD 678 must include duties performed, start and end dates, and hours worked per week for each position held.

Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list eligibility, are in the process of obtaining list eligibility, have LEAP eligibility, or have SROA and/or Surplus eligibility may be considered.

Application Instructions

Completed applications and all required documents must be received or postmarked by the Final Filing Date in order to be considered. Dates printed on Mobile Bar Codes, such as the Quick Response (QR) Codes available at the USPS, are not considered Postmark dates for the purpose of determining timely filing of an application.

Final Filing Date: 9/4/2025

Who May Apply

Individuals who are currently in the classification, eligible for lateral transfer, eligible for reinstatement, have list or LEAP eligibility, are in the process of obtaining list eligibility, or have SROA and/or Surplus eligibility (please attach your letter, if available). SROA and Surplus candidates are given priority; therefore, individuals with other eligibility may be considered in the event no SROA or Surplus candidates apply.

Applications will be screened and only the most qualified applicants will be selected to move forward in the selection process. Applicants must meet the Minimum Qualifications stated in the Classification Specification(s).

How To Apply

Complete Application Packages (including your Examination/Employment Application (STD 678) and applicable or required documents) must be submitted to apply for this Job Posting. Application Packages may be submitted electronically through your CalCareer Account at When submitting your application in hard copy, a completed copy of the Application Package listing must be included. If you choose to not apply electronically, a hard copy application package may be submitted through an alternative method listed below:

Address for Mailing Application Packages

You may submit your application and any applicable or required documents to:

State Compensation Insurance Fund

Mailing Address

Attn: JC-489402 CA

PO BOX 659015

Sacramento , CA 95865

Address for Drop-Off Application Packages

You may drop off your application and any applicable or required documents at:

State Compensation Insurance Fund

Talent Acquisition/Staffing

JC-489402 CA

2275 Gateway Oaks Drive

Sacramento , CA 95833

08:00 AM - 05:00 PM

Required Application Package Documents

The following items are required to be submitted with your application. Applicants who do not submit the required items timely may not be considered for this job:

• Current version of the State Examination/Employment Application STD Form 678 (when not applying electronically), or the Electronic State Employment Application through your Applicant Account at All Experience and Education relating to the Minimum Qualifications listed on the Classification Specification should be included to demonstrate how you meet the Minimum Qualifications for the position.
• Resume is required and must be included.
• Statement of Qualifications - The writing sample should be no more than two pages, typed in Arial 11-point font and double-spaced. Please include your name, Job Control number at the top left of the page and respond to the following question:
  
  1. Describe your past research experience. Be sure to highlight your contributions to the project(s) in which you participated and the methodologies you employed to provide accurate data.

Applicants requiring reasonable accommodations for the hiring interview process must request the necessary accommodations if scheduled for a hiring interview. The request should be made at the time of contact to schedule the interview. Questions regarding reasonable accommodations may be directed to the EEO contact listed on this job posting.

Benefits

State Fund employees are eligible for a number of benefits. Our benefit package includes:

Health Benefits Program (CalPERS)

Retirement (CalPERS)

Employer Health and Consolidated Benefits Contributions

Dental, Vision

401(k) and 457 Deferred Compensation Plans

Employee Assistance Program

Group Legal Services Insurance

Holidays, Vacation/Sick/Other Paid Leave

Flex Elect Reimbursement Program

Wellness and Recognition

Alternate Work Schedules

Transit Pass Program

Tuition Reimbursement

Dependent Scholarship Program

Leadership Training

Mentoring Program

Contact Information

The Human Resources Contact is available to answer questions regarding the position or application process.

Human Resources Contact:
Carl Agulo
(916) 567-4878
CAgulo@scif.com

Please direct requests for Reasonable Accommodations to the interview scheduler at the time the interview is being scheduled. You may direct any additional questions regarding Reasonable Accommodations or Equal Employment Opportunity for this position(s) to the Department's EEO Office.

EEO Contact:
Rosa Gil-Robles
(800) 499-8668

California Relay Service: 1-800-735-2929 (TTY), 1-800-735-2922 (Voice) TTY is a Telecommunications Device for the Deaf, and is reachable only from phones equipped with a TTY Device.

Background Investigation

Prior to employment with State Compensation Insurance Fund, a background investigation (BI) will be initiated.

Job Tags

Permanent employment, Full time, Work at office, Immediate start, Flexible hours,

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