Sr Claims Specialist

Metra; Chicago (IL); On-site; USD 74,000 - 110,000; Full time

Job summary

Metra seeks a Sr. Claims Specialist to investigate and assess agency liability under FELA and related claims. You will coordinate with TPAs, prepare documentation, and support defense counsel.

The role involves deep investigations, accurate reporting, and coordinating internal resources. Requirements include a bachelor’s degree or equivalent, 5 years’ claims experience, and strong analytical, written, and negotiation skills.

Qualifications

• Bachelor's degree or equivalent four years of claims management experience.
• Five years of claims management experience in workers' comp, FELA, property, or personal injury.
• Know-how of risk management, FELA, liability, property damage and subrogation.
• Knowledge of litigation techniques and government agency regulations.
• Proficiency with Microsoft 365 and claims management programs.
• Strong analytical, organizational and negotiation skills.
• Ability to conduct in-depth investigations and witness interviews.
• Willingness to travel within Metra's six-county region.

Responsibilities

• Coordinate information and evidence from multiple departments for claims and TPAs.
• Set reserves based on liability evaluation and damages; negotiate with third parties.
• Investigate and assess liability for FELA, personal injury and property damage claims.
• Review medical reports and support defense counsel with documentation.
• Manage day-to-day team activities; provide guidance and training as needed.
• Promote safe work practices and maintain a safe work environment.
• Travel as required and work outdoors during investigations.

Skills

Microsoft 365

Investigation techniques

Driver's license

Strong communication

Negotation skills

Education

Bachelor's degree

Tools

Claims management software

Job description

Salary Range

$73,623.00 - $110,436.00

Description

The final salary will depend on the candidate's qualifications. Those with 8 years or more of required experience can expect offers up to the midpoint of the salary range. Metra provides full pay ranges so candidates can consider their growth potential.

Qualified veterans who meet the minimum requirements will receive outreach during the recruitment process in accordance with Federal and State laws, including the Illinois Veterans Preference Act. Meeting the minimum qualifications does not guarantee an interview or job offer. The most qualified candidate will be selected.

Metra is one of the largest and most complex commuter rail systems in North America, serving Cook, DuPage, Will, Lake, Kane, and McHenry Counties. The agency is linking communities in Northeastern Illinois by providing safe, reliable, and efficient commuter service.

Metra's Law Department is supported by the General Counsel, who reports to Metra's Board of Directors and CEO. The department provides legal counsel to the Board, Metra's senior leadership and every department in the agency. The department is organized into three teams: Governance/Team Support, Corporate/Regulatory, and Litigation/Risk Management. Metra's Ethics Officer is a member of the department. The Law Department focuses on proactively identifying and addressing legal issues in support of Metra's mission to deliver safe, reliable, efficient, and affordable commuter rail service that enhances the economic and environmental health of Northeast Illinois.

Reporting to the Manager, Claims, the Sr. Claims Specialist will work with a third-party administrator (TPA) to investigate and assess agency liability for personal injury, work related incidents covered under Federal Employers' Liability Act (FELA), and property claims; provide the agency's defense counsel with documentation and administrative support pertaining to interrogatories and production requests; and comply with federal reporting requirements.

The primary duties include: Coordinate the collection of information and evidence from various departments to set up claims and provide TPAs with information required to access liability exposure, set appropriate claim reserves based on liability evaluation, severity of injuries and likely extent of damages, assess risk transfer potential, and tender appropriate claims to third parties for further handling and agency indemnification. Conduct investigations and perform other activities to assess the agency's liability and exposure to FELA, personal injury, and property damage claims; obtain internal documents, claimant and witness statements; photograph accident sites; and measure and canvass the incident areas. Review medical reports to track and record medical bill payments. Coordinate with TPA to assist in the negotiation and resolution of open liability claims. Provide documentation and administrative support to Metra's defense counsel pertaining to interrogatories and production requests. Coordinate team's day-to-day activities, assign tasks/projects and monitor performance, and provide guidance and training, but is not a supervisor. Promote safe work practices and maintain and foster a safe work environment. Generally, works indoors but may at times be required to work outdoors during investigations and may be exposed to some severe weather conditions. Perform otherrelated duties as assigned to meet the ongoing needs of the organization.

Metra is a railroad employer subject to the provisions of the Railroad Retirement Tax Act, not the Social Security Administration.

Requirements

1. Bachelor's degree from an accredited college or university or in lieu of a degree, any combination of education and experience may be substituted for the degree that equals four (4) years in claims management.
2. In addition to #1, must have five (5) years of claims management experience processing workers compensation, FELA, property and casualty, or personal injury claims.
3. Working knowledge of principals, practices, and procedures related to risk management, FELA, general liability, property damage, and subrogation.
4. Working knowledge of litigation techniques.
5. Working knowledge of government agencies (i.e., Federal Railroad Administration (FRA), RRB, and Centers for Medicare & Medicaid Services); regulations (e.g. Medicare Secondary Payer rule and the State Children's Health Insurance Program (SCHIP) Extension Act of 2007), and their record-keeping and reporting requirements.
6. Working knowledge of investigation techniques including evidence and admissibility.
7. Working knowledge of on-line investigation sites to locate claimants and property.
8. Working knowledge of Illinois and Cook County Civil Procedure and Illinois Personal Injury laws.
9. Proficient in Microsoft 365 (Word, Exel, Access) and working knowledge of various claims management programs.
10. Strong analytical, organization, and problem solving skills with attention to details.
11. Strong written and verbal communication and negotiation skills.
12. Ability to conduct in-depth investigations and witness interviews.
13. Ability to prepare detailed, accurate, and objective investigative reports.
14. Ability to establish and maintain working relationships with internal and external stakeholders such as TPAs, outside counsel, and host railroad carriers.
15. Ability to write settlement authority memorandum and briefs.
16. Ability to maintain confidentiality.
17. Must posses and maintain a driver's license.
18. Ability to stand, walk, and/or sit, for extended periods of time.
19. Must be able to operate a vehicle.
20. Must be willing to travel within and outside of Metra's 6-county region.
21. Must be available on-call 24-hours/day, 7 days/week, 365 days/year, including weekends and holidays.

Metra employees in an active review period under the current discipline policy or who have documented attendance or performance issues will not be considered and/or selected for this position.

Some positions require an Enhanced Background Check due to the nature of the role. This may include additional criminal history, employment and education verification, credential validation, and other legally permissible checks. All screenings are conducted in compliance with applicable laws and require candidate authorization.

Please note: Regardless of any state laws that legalize marijuana, Metra prohibits applicants and employees' use or possession of marijuana (or marijuana paraphernalia), or having detectable amounts of marijuana in their bodies, including synthetic and/or non-synthetic substances such as THC for any reason for preemployment screening purposes, while on duty, subject to duty, on Metra property, or in Metra work equipment and vehicles.

Metra is committed to ensuring that our career website and recruiting process are accessible to all individuals. For general assistance, please contact [e-mail]. If you require reasonable accommodations to complete this application, participate in interviews, complete any pre-employment testing, or engage in any other aspect of the employee selection process, please direct your inquiries to the Reasonable Accommodations Committee at [e-mail].

Metra is an Equal Opportunity/Affirmative Action Employer. It is our policy to fill vacant positions with qualified candidates without regard to race, color, sex, religion, national origin, age, gender identity, disability, or any protected categories, assuming an individual can perform the essential functions of the job with or without accommodation.