To assist professional Risk Management staff with routine duties in the administration and maintenance of insurance programs; reviews and examines claims, under supervision performs adjustment functions for routine liability, medical malpractice, or other insurance claims.
SUPERVISION RECEIVED AND EXERCISED
Direction is provided by the Risk Manager or Assistant Risk Manager.
DUTIES May Include, But Are Not Necessarily Limited To
Perform claims examination and adjustment functions for the liability, malpractice or other insurance programs. Receive, review and analyze claims and accident reports to determine the nature of the injury or claim. Ascertain the validity of the claim through research and develop recommendations for corrective action or resolution. Gather facts and data, interview witnesses, and write briefings, reports and memorandums. Coordinate assignment and work of independent adjusters and third party administrator in investigating claims. Adjust claims with guidance from the Risk Manager, County attorneys, doctors, claims investigators, claimants, and claimant's attorneys. Develop information and tentative conclusions to support recommendations to the Risk Manager or Assistant Risk Manager for settlements of liability claims. Assist Risk Manager to establish reserves for claims using defined set of guidelines and industry standards. Review and recommend approval of bills for payment. Prepare routine documents pertaining to contractual or legal proceedings such as standard releases, waivers and agreements. Coordinate routine inter-departmental administrative and communications functions such as scheduling meetings, preparing agendas, responding to departmental inquiries on less complex claims, composing and distributing letters, memorandum and other written materials.
Perform related duties as assigned. (Essential duties may vary from position to position within this classification. Reasonable accommodation will be made when requested and determined by the County to be appropriate under applicable law.)
NECESSARY EMPLOYMENT STANDARDS
Knowledge of: Methods and techniques of information gathering and interviewing; math sufficient to compute and verify calculations on claims; functions, procedures, and practices of a modern office environment.
Skill/Ability to: Adjust less complex claims under direction of the Risk Manager and in consultation with County's Attorneys, doctors, claims investigators, claimants and claimants' attorneys; gather information through interviews and research regarding the validity of claims; develop and maintain accurate electronic and paper records; review and recommend payment of bills; organize work in a step-by-step order; read, interpret and apply legal rules and regulations; write clear and concise reports, letters, and procedures; communicate verbally in a clear, concise and self-assured manner; establish and maintain cooperative working relationships with employees, claimants, professionals, and other agencies; work under stress of meeting deadlines; utilize a personal computer including word processing and spreadsheet software.
Education and Experience: Any combination of education and experience that could likely provide the required knowledge, skills, and abilities is qualifying. A typical way to obtain the knowledge, skills, and abilities would be equivalent to completion of twelfth grade, supplemented by specialized administrative or secretarial training, or courses in public, business, or insurance administration AND three (3) years of progressively responsible experience in a public agency performing insurance claims adjusting or processing, administrative support, or secretarial work.
Possession of, or ability to obtain an appropriate, valid California driver's license.
Visalia TimesDelta. Keywords: Claim Attorney, Location: Visalia, CA - 93290
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