Senior Claims Adjuster

Rc HR; Riverside, Northern (CA, KY); Hybrid; USD 90,000 - 130,000; Full time

Job summary

The County of Riverside Department of Human Resources seeks a Senior Liability Claims Adjuster to investigate, adjudicate, negotiate, and direct complex tort claims within monetary authority. The role includes site inspections, mediation support, and coordination with excess carriers to prepare cases for litigation.

Ideal candidates bring journey-level liability claims experience, strong analytical skills, and the ability to communicate findings to attorneys and stakeholders.

Qualifications

• Bachelor's degree or equivalent education required.
• Five years journey-level experience in general liability claims including litigation management.
• Experience reporting claims and subrogation to third party insurers is preferred.
• Knowledge of California laws and liability regulations is essential.
• Ability to analyze medical reports and expert opinions for liability and damages.

Responsibilities

• Receive, review, and adjudicate public liability claims; evaluate medical reports to determine liability and damages.
• Provide exceptional customer service to stakeholders and prepare summaries of complex issues.
• Gather data, review claims documentation, and follow up as needed.
• Conduct investigations, interview witnesses, and prepare investigative findings.
• Represent the County in small claims actions and manage litigation readiness.
• Consult with attorneys to prepare cases for litigation and maintain claims records.

Skills

Claims investigation

Litigation management

Subrogation recovery

Legal and regulatory knowledge

Analytical thinking

Communication with stakeholders

Education

Bachelor's degree

Tools

Claims data reporting software

Job description

The County of Riverside Department of Human Resources is seeking an experienced and dynamic Senior Liability Claims Adjuster to join the Risk Management Division in Riverside. The Senior Liability Claims Adjuster will investigate, analyze, adjudicate, negotiate, and direct a diverse range of complex tort claims within assigned monetary authority and manage the litigation aspects of these claims on behalf of the County of Riverside. The types of claims include but are not limited to police practices exposures, child protective services matters, auto accidents, alleged dangerous road condition cases, etc. In addition to managing a pending case count and new claims, the Senior Liability Claims Adjuster will conduct site inspections, prepare quarterly meetings with departments and our excess insurance carriers, attend mediation and court-imposed settlement conferences, analyze contracts for indemnification and insurance provisions and provide recommendations to county departments and present training to educate stakeholders and peers about Risk Management.

Competitive candidates will have extensive journey level experience in a broad range of commercial insurance or large public sector liability claims including reporting claims of subrogation to third party insurance carriers, preparation and presentation of cases at small claims court and litigation management. The Department desires candidates proficient in the practice of determining the valuation of a claim property depreciation. Those with computer application programs used to report claims data with the ability to maintain an effective working relationship with professional legal staff, attorneys, department heads, managers and stakeholders.

At this time, the position has the opportunity for a hybrid telework schedule based on business need; however job expectations, at times, will require in-person interaction. Telework may change at any time and you may be expected to report to the office.

This position is currently a full‑time companion position with benefits. It is expected that this position will become a full‑time regular position in the near future.

Meet the team!

The Human Resources Department strives to effectively serve and partner with our community, departments and employees by leveraging best practices and innovation to foster a thriving county.

Responsibilities

• Receive, review, accept or deny public liability claims including malpractice, property and personal claims; evaluate medical reports and reports of experts to determine extent of liability and damages; evaluate merit of claims and recommend settlement or denial of claims; estimate anticipated settlement value, make adjustments and settle claims within assigned monetary authority.
• Provide exceptional customer service to all stakeholders.
• Provide high level summaries of complex issues.
• Gather and review data, reports, and other claim documentation; request clarifying or additional information; review status and perform necessary follow up.
• Conduct investigations to determine circumstances involved in claims against the County; including interviewing witnesses and inspecting the scene of accidents, injuries, or property damage; prepare investigative report of findings.
• Investigate difficult and complex public liability claims and those involving a greater degree of sensitivity and/or complexity.
• Conduct interviews with parties responsible for damage to County property and injuries to County employees to ensure collection of payments; contact public and private organizations/agencies to obtain collections information; recommend actions necessary to enforce collections including court actions or liens.
• Represent the County in small claims actions.
• Prepare reports of costs and status on active and closed claims.
• Consult attorneys to prepare cases for litigation. Serve as custodian of records; provide subpoenaed records and attest to their validity.
• Assist the program supervisor to develop and maintain claims records and computer record‑keeping systems; assure accuracy conformance to policies and procedures and accessibility of claims records. Assist attorneys in the preparation of complex case for litigation ensuring the availability and accuracy of all necessary documentation.

Job Competencies

• 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.

Other Requirements

License: A valid California Driver's License is required at the time of appointment or the ability to arrange transportation for field travel. The incumbent may be required to use a personal vehicle and provide verification of auto insurance coverage as required by the County of Riverside.

Schedule

At this time, the position has the opportunity for a hybrid telework schedule based on business need; however job expectations, at times, will require in-person interaction. Telework may change at any time and you will be expected to report to the office.

Questions

Please contact Angela Tavaglione at [e-mail] or [phone]. Please allow 1-2 business days for response.

Education

Graduation from an accredited college or university with a bachelor's degree or equivalent education (minimum completed units equaling 120 semester/180 quarter).

Experience

Five years of journey-level experience investigating general liability, including litigation experience and managing high exposure and complex files and property claims including 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

Provide exceptional customer service to all stakeholders, provide high level summary of complex issues, 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.