Claims Adjuster

Baltimore County; Towson (MD); On-site; USD 65,000 - 90,000; Full time

Job summary

Baltimore County seeks an experienced claims analyst to investigate, negotiate, and settle claims against the County's Self Insurance Fund. You will review workers' compensation, liability, and property-related claims and prepare documentation for potential litigation.

You will maintain detailed claim files, assess risk, and coordinate with the Office of Law. A bachelor's degree and two years of claims experience are required.

Qualifications

• Bachelor's degree in business, public administration, risk management, law, or a closely related field.
• Two years' experience adjusting and managing insurance claims for worker's compensation, vehicle liability, and/or general liability.

Responsibilities

• Investigate, negotiate, and settle insurance claims in accordance with laws and county policies.
• Review and process workers' compensation, vehicle liability, and general liability claims; identify risk exposure.
• Maintain detailed claim files and prepare reports for litigation readiness.

Skills

Claims adjustment

Negotiation

Communication

Record keeping

Education

Bachelor's degree in business, public administration, risk management or related field

Job description

Pay Schedule XII, Grade 1M

A vacancy exists in the Office of Law.

A list of eligible applicants will be established based on the examination as outlined below.

Under general supervision, investigates, negotiates, and settles claims against the County's Self Insurance Fund and evaluates the investigation and analysis of such claims in preparation for litigation.

• Reviews, analyzes and processes workers' compensation claims. Investigates injuries and accidents arising from County operations. Reviews bills and corresponding reports related to claims to determine if compensable under State law and County policies. Interprets data to identify risk exposure and recommend corrective or preventative measures, where needed, to reduce accidents and injuries.
• Receives, analyzes, and processes reports of damage to County insured property or vehicles. Investigates claims alleging negligent operation of County insured vehicles. Receives, analyzes and processes claims alleging injury or damages arising out of condition of County insured property, County operations, or actions of County employees or volunteers. Determines the type of investigation required.
• Documents and maintains detailed claim files. Compares data on claim form with physician's statements, police investigative reports, damage appraisal reports, and other records to ascertain completeness and validity of claims. Identifies claims for subrogation and pursues recovery of funds from third party.
• Prepares statistical, narrative, or other reports. Assists the claims manager in review and evaluation of claims in preparation for litigation by assessing compliance with all of the Claims Management Unit's standard operating procedures. Performs the claims handling function in compliance with Maryland Workers' Compensation Law, Baltimore County policies, and the policies and procedures of the Claims Management Unit. Establishes appropriate reserves and resolution plans on all claims. Coordinates claim function with other activities of the Claims Management Unit. Assists in the preparation of claims for hearings and/or trials by gathering pertinent information and forwarding documentation to the Office of Law. May attend hearings or court proceedings as needed.

Examples of Other Duties

Participates in developing and implementing new or revised policies and procedures.

Performs other related duties as required.

(NOTE: The duties and responsibilities listed above are for the purpose of determining a common set of minimum qualifications for all positions in this class. They may not include all of the essential job functions of each position in the class. Each position may not be required to perform all of the essential job functions listed.)

Required Qualifications

Graduation from an accredited college or university with a bachelor's degree preferably in business or public administration, risk management; law, or a closely related field

two years' experience in adjusting and managing insurance claims for worker's compensation, vehicle liability, and/or general liability. (Additional experience may be substituted on a year-for-year basis for the required education. Additional education in business or public administration, risk management, law, or a closely related field may be substituted on a year-for-year basis for the required experience.

Knowledge, Skills, and Abilities (Entry Level)

• Thorough knowledge of claims adjustment related to workers' compensation, vehicle liability, and/or general liability. Knowledge of insurance laws and regulations. Knowledge of self-insurance programs. Knowledge of subrogation claims.
• Skill in investigating, negotiating, and settling insurance claims. Skill in reading and interpreting various reports and documents in order to resolve claims issues. Skill in maintaining detailed claim records. Skill in preparing narrative and statistical reports.
• Ability to analyze insurance risk. Ability to establish and maintain effective working relationships with various contacts. Ability to communicate effectively.

Knowledge, Skills, and Abilities (Full Performance)

• Thorough knowledge of the principles and practices of self-insurance programs. Knowledge of the principles of loss control and risk exposures common to governmental operations. Knowledge of Maryland Workers' Compensation laws, rules, and regulations. Knowledge of the organizational structure and functions of County government. Knowledge of County and departmental rules, regulations, policies, and procedures. Knowledge of the policies and procedures of Baltimore County's Workers Compensation and/or Liability Claims Unit and proficiency in the use of Baltimore County's electronic file management system.
• Skill in administering claims through a self-insurance funded program.

Licenses and Certificates

Possession of a valid driver's license equivalent to a non-commercial, class C Maryland driver's license is required at the time of appointment.

Proof of Licenses, Certifications and Education

Applicants are required to submit proof of licenses, certifications and education beyond high school to meet the required and preferred qualifications of the position. Diplomas or transcripts must show the applicant’s major field of study. Copies and unofficial transcripts are acceptable.

Proof of Degree Equivalency

Applicants who have obtained a degree from outside the United States of America are required to submit degree equivalence documentation from World Education Services, Inc. (www.WES.org)

EXAMINATION PROCEDURE

Applicants will be qualified based on an evaluation of their training and experience, as stated on their application. Applicants must state the dates and duties of past and present experience clearly and completely for evaluation purposes.

Physical and Environmental Conditions

The work of this classification is essentially sedentary. Some positions may require travel to other work sites.

Employment Background Investigation

Applicants selected for an appointment to a position in Baltimore County must successfully complete an employment background investigation, including, but not limited to a criminal background, education, and fingerprint check.