Claims Manager

City of El Paso; El Paso (TX); On-site; USD 90,000 - 130,000; Full time

Job summary

City of El Paso seeks a seasoned professional to manage its workers’ compensation, property/casualty, and subrogation programs. You will identify and mitigate risks, coordinate claims processing, and partner with departments to transfer risk using self-insurance and commercial instruments.

Include supervising staff and ensuring compliance. Eligibility includes a four-year degree in a related field and 2+ years of supervisory experience, plus required licenses within a year.

Qualifications

• Bachelor’s degree in Business or Public Administration, Finance, Risk Management, Insurance or related field and 4 years’ professional experience in administering workers’ compensation, property/casualty insurance claims, self-insurance or captive programs, incl. 2 years lead/supervisory experience.
• Texas Driver’s License (Class C) required; Workers’ Comp Adjustor license within 1 year; Property & Casualty Adjuster license within 1 year.
• ARM and/or Certified Claims Examiner preferred.

Responsibilities

• Manage City of El Paso insurance programs including workers’ compensation, property/casualty, and subrogation/recovery claims.
• Identify, assess, and mitigate risks associated with human, physical, and liability claims; coordinate claims processing and risk transfer strategies.
• Coordinate with internal partners to establish risk framework; manage claims to full resolution.
• Administer return-to-work/transitional duty program; oversee third-party administrator processes on workers’ comp claims.
• Provide education and training to employees on claims matters and ensure regulatory compliance.
• Supervise assigned staff: assign, train, evaluate, and develop personnel; enforce rules impartially.

Skills

Leadership

Risk management

Claims administration

Budget management

Training and development

Communication

Education

Bachelor's degree in Business or Public Administration

ARM (Associate in Risk Management)

Certified Claims Examiner (Texas)

Tools

RMIS

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 lead or supervisory experience.

Licenses and Certificates

Valid Texas Class \"C\" Driver's License or equivalent from another state by time of appointment. A Workers’ Compensation Adjustor’s license is required within one (1) year of appointment. Property & Casualty Adjuster License required within one (1) year of appointment. An Associate in Risk Management from the Insurance Institute of America and/or Certified Claims Examiner Certification from the State of Texas is preferred.

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

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

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.

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.