Claims Adjuster II (Finance)
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The Human Resources Department has an opportunity for a Claims Adjuster II to join the Liability Insurance team with our Risk Management Division located in Riverside.
The Liability Claims Adjuster II will manage a caseload of liability claims that are filed against the County of Riverside. The body of work includes intake, investigation/preparation, and overall resolution of liability claims. Additionally, the Claims Adjuster II will make small claims appearances on behalf of the County. This is the journey level class in the series and, under general supervision, incumbents are responsible for performing independent liability claims or medical malpractice casework of above average difficulty with responsibility for investigative and decision-making functions for claims including case evaluation and negotiating their cases to a satisfactory conclusion. The incumbent will also be tasked with reporting which requires navigating various systems and research of legal documents.
The most competitive candidates will have extensive journey level experience in the field of commercial liability claims, litigation, and subrogation experience as well as experience in managing a liability claim caseload from the initiation to resolution. Candidates who possess a bachelor's degree and those with experience working directly for major insurance carriers, third party administrators and/or in general liability experience are highly desired and encouraged to apply!
Meet the Team!
The Human Resources Department seeks and develops talented professionals that fit a highly engaged and collaborative culture.• Receives, reviews, accepts or denies public liability claims including malpractice, property and personal claims; evaluates medical reports and reports of experts to determine extent of liability and damages; evaluates merit of claims and recommends settlement or denial of claims; estimates anticipated settlement value makes adjustments and settles claims within assigned monetary authority.
• Gathers and reviews data, reports and other claim documentation; requests clarifying or additional information; reviews status and performs necessary follow up.
• Conducts investigations to determine circumstances involved in claims against the County; including interviewing witnesses and inspecting the scene of accidents, injuries or property damage; prepares investigative report of findings.
• Conducts interviews with parties responsible for damage to County property and injuries to County employees to ensure collection of payments; contacts public and private organizations/agencies to obtain collections information; recommends actions necessary to enforce collections including court actions or liens.
• Represents the County in small claims actions.
• Prepare reports of costs and status on active and closed claims.
• May authorize subrogation, court actions or liens when collections can not be obtained by other means; reviews and makes recommendations for suspension, modification, garnishment or other legal actions; corresponds with attorneys, insurance carriers and others; interprets legal procedures involved in the collection or subrogation accounts.
• Consults with attorneys to prepare cases for litigation.
• Serves as custodian of records; provides subpoenaed records and attests to their validity.
• May prepare and present training program educating staff about the Liability Claims Program.
• May assign and review the work of others and provide training to new employees.
Senior Liability Claims:
• Investigates difficult and complex public liability claims and those involving a greater degree of sensitivity and/or complexity.
• Assists the program supervisor to develop and maintain claims records and computer record keeping systems; assures accuracy conformance to policies and procedures and accessibility of claims records.
• Assists attorneys in the preparation of complex case for litigation ensuring the availability and accuracy of all necessary documentation.
• Assigns and reviews the work of Adjusters and Technicians; trains and provides technical assistance to new and journey-level Adjustors.
• Assists the Liability Claims Program Supervisor with the implementation of special programs; assists in the supervision and maintenance of statistical and budget records and participates in studies.Experience: Extensive journey-level experience of at least 5 years reviewing and processing property damage liability claims including investigating, identification and investigation of fraud cases, adjusting and settling a wide variety of claims.
Knowledge of: Rules, regulations, and laws regarding personal and property liability including, but not limited to, general provisions of California Vehicle Code, State and Federal Government Codes, laws and statutes and legal decisions pertaining to personal and property liability; Methods and techniques of subrogation recovery; Technical medical terminology related to the cause and treatment of physical injuries; Practices and procedures of insurance reserving, risk and experience analysis and statistical record keeping.
Ability to: Gather and evaluate all information pertinent to liability claims and make appropriate recommendations; Establish and analyze all relevant data, effect necessary control plans, and bring all claims to equitable conclusion; Develop action plan necessary to implement recommendations with a minimum of guidance.
Other requirements
License: possession of a valid California driver's license is required.
Telework hybrid may be available after initial training requirements have been met but not guaranteed.Job Competencies:
Work Performance Measures
• Effectively analyze and interpret federal and state laws affecting claims.
• Successfully discern and analyze alternatives in technical situations to assist in problem resolution.
• Participate appropriately in meetings as directed by the Workers' Compensation Officer or Liability Claims Program Supervisor.
• Accurately assess and calculate claim settlement costs.
• Successfully analyze information to determine appropriate strategy.
• Succinctly and clearly develop written reports and recommendations as assigned.
• Skillfully utilize computer and other available technology to maintain claims records, supporting documentation and technical/legal information.
• Meet obligations and commitments.
• Effectively investigate a wide variety of claims, data sources, regulations and laws governing claims.
• Take appropriate actions after carefully determining and analyzing all relevant factors.
• Maintain objectivity and credibility.
• Effectively maintain expertise in claims areas impacting the County including legal climate and trends.
• Appropriately utilize creative problem solving, investigative and analysis techniques.
• Persuasively communicate your findings and recommendations to a variety of audiences including attorneys and insurance representatives.
• Successfully prioritize conflicting timelines ensuring that each case or project receives appropriate time and consideration.
General Information:
This recruitment is open to all applicants.
For specific questions regarding this posting please, contact Angela Tavaglione at atavaglione@rivco.org or at (951) 966-3590.
