Claims Specialist
Location: Albuquerque, New Mexico
Description: Bernalillo County Government is hiring Claims Specialist right now, this position will be reside in New Mexico. For complete informations about this position opportunity please give attention to these descriptions.
Position Summary & Duties Responsible
POSITION SUMMARY
Under general direction of the Risk Management Claims Manager, diligently investigate, research, evaluate, and process a range of claim ty pes on behalf of Bernalillo County. Provide excellent customer service to both internal and external customers.
Range of claims types will include, but may not be limited to, workers' compensation, property/casualty, auto, and general liability. Assure compliance with all applicable laws, rules, and regulations related to claim handling.
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 on this job description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties and responsibilities required of all employees assigned to this job.
Minimum Qualifications
- Seven (7) years of experience in claim administration or processing within the worker's compensation, property/casualty, auto, general liability insurance field; OR any combination of education from an accredited college or university in business administration or another related field with direct experience in this occupation totaling 7 years may substitute for the required education and experience. Related education and experience may be interchangeable on a year for year basis. Any certifications recognized in the insurance industry are also desired, but not required.
- Knowledge of principles and practices for evaluating, investigating and processing of worker's compensation claims, property/casualty claims, auto claims, general liability claims, and related matters.
- Knowledge and ability to apply Federal, State of New Mexico and County of Bernalillo statutes, ordinances, policies and industry standards to ensure compliance with proper handling and administration of claims.
- Skill and ability to communicate effectively in both oral and written English when dealing with internal and external parties.
- Knowledge of worker's compensation , property/casualty, auto, and general liability insurance industry, as well as knowledge of medical and legal terminology that may pertain to claim processing.
- Knowledge and skill in data processing, data entry, database management, and spreadsheet formulation.
- Ability to interact professionally with the public, management, and other staff employees.
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.
- 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 wit h a group at times and with a select team at times.
- Equipment used in performing duties includes: computer, camera, recording equipment, telephone, calculator, facsimile machine, and photocopy 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.
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If you were eligible to this position, please deliver us your resume, with salary requirements and a resume to Bernalillo County Government.
Find doctor resume sample sample here.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position will be opened on: Fri, 04 May 2018 17:41:45 GMT