Claims Manager

Full Job Description

MOS Codes: None

Education and Experience: Bachelor’s Degree or higher in Business or Public Administration, Finance, Risk Management, Insurance, or a related field, and four (4) years of professional experience administering workers’ compensation, property and casualty insurance claims, self-insurance, or captive insurance programs, including two (2) years of supervisory experience.

Licenses and Certificates: Valid Texas Class "C" Driver's License or equivalent from another state by time of appointment.

Workers’ Compensation Adjustor’s license is required within one (1) year of appointment. Property & Casualty Adjuster License required within one (1) year of appointment.

Associate in Risk Management from the Insurance Institute of America and/or Certified Claims Examiner Certification from the State of Texas is preferred.

Requirements

Under the direction, manages the City of El Paso insurance programs including workers’ compensation, property/casualty, and subrogation/recovery claims.

Qualifications

Identify, assess, and mitigate risks associated with human, physical, and liability claims.

Involves: Administer and coordinate claims processing and implement strategies to prevent, control, and/or transfer risks through claims management processes and procedures, self-insurance, commercial insurance, and /or other financial instruments.

Coordinate with internal business partners to establish a framework and methodology to mitigate reported incurred and/or incurred but not yet reported losses.

Manage all claims, with varying degrees of complexity, to full and successful resolution.

Manage and administer non-tort claims and seek recovery of damages. Involves: Administer medical/case management, claims strategy, negotiation, and adjudication of claims within the level of authority.

Initiate and monitor claims investigations, and accept or deny claims. Monitor and ensure the accuracy of claims financial data maintained in the Risk Management Information System (RMIS).

Set financial reserves for claims and conduct periodic internal reserve audits. Represent the City of El Paso at settlement conferences, hearings, arbitrations, mediations, and trials.

Negotiate settlements on behalf of the City within the limits of authority. Administer the return-to-work/transitional duty program for injured workers.

Manage third-party administrator processes on workers’ compensation claims. Provide all tort notices to the City Attorney’s Office upon receipt.

Claims administration: Involves: Establishing processes, policy, and priorities, developing and implementing procedures on claims processing and maintenance of claims data, program integrity, and controls.

Conduct periodic claims reviews and management meetings with departments, third-party claims examiners/adjusters, and City Attorney’s Office. Advise supervisor on annual claims program budget needs.

Communicate claims management philosophy, case strategy, and financial implications to management.

Review and finalize workers’ compensation regulatory reports and ensure compliance with reporting requirements.

Maintain current knowledge of changes to workers’ compensation, property/casualty, and subrogation/recovery statutes, and act as an in-house resource for departments.

Provide education and training to employees on claims matters, especially workers’ compensation response and policies/procedures.

Manage and coordinate recoverable claims to successfully subrogate and facilitate insurance recoveries.

Assist with Total-Cost-of-Risk analysis, insurance, and self-insured cost forecasting, and data analysis including reviewing and providing input on data trends and variances.

Serve on special project teams and assignments.

Supervise assigned staff. Involves: Assign, schedule, guide, and monitor work. Appraise employee performance and review subordinate supervisors' appraisals. Provide for training and development.

Counsel, motivate, and maintain harmony. Identify and resolve staff differences, conflicts, and deficiencies. Interview applicants.

Recommend hiring, discipline, termination, promotion, or other employee status changes. Enforce personnel rules and regulations and work behavior standards firmly and impartially.

Additional Information

For complete job specification, click here.

Note: Applicants are encouraged to apply immediately. This position will close when a preset number of qualified applications have been received.

Important Note: The required Supplemental Questions and answers are considered an examination component and will generate a score.

Applicants are being tested on a conditional basis pending a review of minimum qualifications. Applications will be reviewed for applicants who pass the Supplemental Questions exam.

Per CSC Rules & Regulations, after review of the minimum qualifications for applicants that pass the Supplemental Questions exam, a passing score, combined with applicable seniority points and veteran points, will be used to create a list of candidates.

Note: Applicants with foreign diplomas, transcripts and degrees must have all documents translated and evaluated by an agency of the National Association of Credential Evaluation Services (NACES) prior to submitting them to the Human Resources Department.

Please visit www.naces.org/members for more information. A résumé and/or other documents will not be accepted in lieu of a completed application.

Comments such as “See résumé” are not acceptable and will result in the application being considered incomplete.

To qualify for this position, the required education, experience, knowledge, and skills must be clearly stated on your application’s employment history.

We do not use any information on your resume to review if you meet the minimum qualifications for this position.

Failure to fully detail all experience and job duties in the application, or copying/pasting directly from the job specification, or responses referring to your résumé will eliminate you from consideration for the position.