Job Title

Job Family

Job Code

Job Exempt

Claims Supervisor

Seiu_Supervisory

AHM30

Pay Grade

Pay Rate Type

Minimum

Midpoint

Maximum

S11

Salary

$28.90

$38.30

$47.69

Job Description

Performs responsible professional and lead work ensuring professional, ethical, and timely handling of all workers’ compensation, auto liability, general liability, and police legal liability claims to determine if the City is liable for injury or damage and how to most efficiently manage and/or resolve these claims. Duties include daily review of open files, personally handling complex files, establishing appropriate reserves, attending mediations and trials, and interacting with directing staff. An employee assigned to this classification is required to have a high degree of professionalism, discretion, and independent judgment in determining liability based upon City Policies and other legal principles, including Florida Statutes and Case Law. An employee in this classification conducts physical inspections which involve driving, walking, and some field work in all types of weather conditions. Work involves the supervision of staff adjusters, coordination of contracted adjusters, investigators and outside legal counsel. Work is reviewed by the Risk Manager through conferences, reports submitted, and effectiveness of results achieved.

Minimum Qualifications:

Bachelor's Degree in Public/Business Administration, Insurance, Finance, Accounting or related field and three (3) years professional experience adjusting workers’ compensation claims, some lead/supervisory experience required; or an equivalent combination of related education, training and experience. State of Florida All Lines Adjuster License required. Valid Florida Driver's License required.

Responsibilities

EXAMPLES OF WORK PERFORMED:

Note: The listed duties are only illustrative and are not intended to describe every function that may be performed by this job class. The omission of specific statements does not preclude management from assigning specific duties not listed if such duties are a logical assignment to the position.

Provides technical assistance to Workers’ Compensation Claims Adjusters and Liability Adjusters; assigns, reviews and monitors work and ensures timely and accurate issuance of all claim payments.

Settles claims up to $24,999 independently.

Investigates workers' compensation claims, and other claims involving personal injury; investigates scene of accidents, takes detailed statements from involved parties, photographs evidence to document investigation files, performs other research as necessary.

Represents the City at claim settlements; negotiates settlement claims up to an authorized limit or makes recommendations for settlement to the Risk Manager; attends trials and mediations.

Processes all claims from initial report to final disposition and responds to all inquiries in a timely fashion.

Conducts loss trend analysis and generates reports.

Advises City personnel and affected individuals of City claims procedures in person and over the phone.

Confers with appropriate City officials, doctors, lawyers, judges, insurance carriers outside actuaries, regulatory agencies, and other interested parties.

Serves as a contact for contracted adjusters, investigators and outside legal counsel.

Attends safety meetings and the Accident Review Board; works with Safety Specialist in determining accident prevention strategies.

Performs of related duties as required.

KNOWLEDGE, SKILLS AND ABILITIES:

Knowledge of State statutes and administrative code, insurance rules and regulations.

Knowledge of medical and legal terminology, and managed care requirements.

Knowledge of reference materials in the field of casualty and loss.

Knowledge of the legality of claims relating to worker's compensation or auto liability or general liability claims.

Knowledge of claims investigation methods and techniques.

Skilled in research techniques.

Ability to train, assign, and review work of lower level employees.

Ability to communicate effectively, orally and in writing, with City employees, upset and/or irate individuals, defense and claimant counsel, doctors, lawyers, judges and insurance carriers.

Ability to establish and maintain effective working relationships with employees, the public, attorneys, and professional and private organizations.

Ability to determine value of a claim and negotiate equitable settlements.

Ability to prepare written reports.

Ability to process claims and to respond to inquiries in a timely manner.

Ability to read and understand estimates.

Ability to operate camera, tape recorder, personal computer, and automobile in order to completes claim investigations.

Ability to lift and carry boxes of files, stand for extended periods, climb ladders, work outdoors in varying conditions.