DUTIES AND RESPONSIBILITIES
- Monitor strategy and progress of County claims adjusted by insurance companies, third party administrators, and self-insurance pools.
- Serve as the point of contact for claims and as liaison between insurance carriers, attorneys, investigators, vendors
- providing claims related services, Risk Management staff and other County personnel, medical providers, and County administration.
- Work with insurance companies, self-insurance pools, third party administrators, County Legal, and other County departments to coordinate the gathering, collection and organization of discovery material.
- Investigate, research, analyze and evaluate claims, forwarding required documentation to insurance companies, third party administrators, and self-insurance pools.
- Attend and participate in mediations and hearings as assigned.
- Verify services completed for invoice payments of worker's compensation, property/casualty, auto, or general liability claims.
- Responsible for the coordination and maintenance of paper and electronic claim files.
- Prepare comprehensive reports and correspondence related to claims, coverage, and losses by utilizing database and spreadsheet capabilities.
- Research claim information for safety and loss control purposes; analyze data, identify potential risks to which the County is exposed, and make recommendations for implementation of loss control measures.
- Assist in the development and implementation of policy and procedures related to claims management, loss control, and insurance providers.
- Monitor developments and trends affecting the insurance industry, such as changing case law, industry best practices, or industry standards.
- Coordinate with Safety and create and/or conduct presentations.
- As directed, assist with or prepare any Occupational Safety and Health Administration (OSHA) logs and reports.
*The above information is intended to outline the general nature and scope of the duties required for this position. It is not an exhaustive list and may vary depending on specific job assignments and responsibilities.
MINIMUM QUALIFICATIONS
- High School Diploma or GED.
- Five (5) years of work experience in claim administration/processing within worker’s compensation, property/casualty, auto, and general liability insurance field.
*Any equivalent combination of related education and/or experience may be considered for the above requirements.
SUPPLEMENTAL INFORMATION
SCREENING AND COMPLIANCE
The offer of this Bernalillo County position requires compliance with the following:- Employee must successfully complete the post-offer employment medical examination.
- Employee must comply with the safety guidelines of the County.
WORKING CONDITIONS
- Essential job duties are performed indoors in a climate-controlled environment.
- Primary work surface is even, dry, carpeted or tiled floor.
- Works alone primarily, with or without directions. Works with a group at times and with a select team at times.
EQUIPMENT, TOOLS, AND MATERIALS
- Equipment used in performing duties includes: computer, camera, recording equipment, telephone, fax machine, and copy machine.
- Materials and products handled on performance of duties include: logs, spreadsheet, graphs, pie charts, writing utensils, safety manual, rules and regulations, and various office forms.