Unit Process Manager

Minimum Qualifications

Bachelor’s degree in business administration with major course work in insurance and risk management or related field and two years professional level experience in workers’ compensation claims adjusting; or any equivalent combination of related training and experience. Must possess a valid Florida independent claims adjuster license and/or workers’ compensation adjuster license within six months of employment. Must possess valid Florida driver’s license at time of application.

Requires the successful completion of a criminal history background investigation prior to employment. Applicants within six months of meeting the minimum education/experience may be considered for trainee status. Applicants with a Safety background desirable. This position will serve as a Liability Claims Investigator/Adjustor and Loss Control Specialist.

This is responsible professional and advanced specialized technical work involving administrative responsibility for coordinating one or more Risk Management functions including insurance/self-insurance claims and risk mitigating areas and occupational safety in the Department of Administrative Services, Office of Risk Management. An employee assigned to this classification is responsible for administering and directing programs to ensure safety training including accident control, the proper and efficient handling of liability and workers’ compensation claims, gathering data on claims for both record keeping and loss forecasting purposes, and estimating the financial value of claims.

This employee is also responsible for post loss reduction techniques such as salvage, subrogation and rehabilitation, as well as, resolving bona fide claims at the least possible cost to the County. Work is performed under the direction of a higher level supervisor and is reviewed through conferences, reports and observation of results obtained.

• Conducts investigation of reported incidents of personal injury and employment practices which may result in claims against the self insured fund.
• Conducts field accident investigations by locating and questioning witnesses, claimants, law enforcement officers, and other parties; obtains signed statements of incidents.
• Assists in the gathering of formal evidence by taking photographs, preparing diagrams and making measurements at accident scene.
• Arranges for witnesses to appear at legal proceedings.
• Adjusts and prepares settlement offers on third party liability claims.
• Maintains a calendar of mediation and trial dates.
• Works directly with the County’s Third Party Administrator (TPA) by providing review and analysis of Workers’ Compensation claims/issues and recommends appropriate action.
• May authorize medical treatment in Workers’ Compensation cases.
• Prepares accident reports.
• Consults on injury cases with various medical personnel in order to ascertain the extent and cost of treatment, loss of earning capacity and prognosis; confers with physician and attorney, if necessary, on employment limitations.
• Maintains accurate records of cases in progress and prepares reports for claims determination.
• Maintains and prepares periodic statistical reports accounting for all funds collected and disbursed; prepares and submits documentation for approval of all variations in cost and collection.
• Establishes and maintains assigned claims, accidents and occurrence case files; testifies in hearings to the content and validity of the case record.
• Reviews and ascertains accuracy of medical treatment charges submitted for payment.
• Monitors financial reserves for claims payment.
• Attempts to effect equitable settlement without litigation.
• Compiles data, prepares and maintains fiscal statistics.
• Performs related work as required.

Knowledge of safety regulations. Considerable knowledge of the principles and practices of local government administration. Considerable knowledge of investigative and adjustment techniques, procedures and practices involving bodily injury and property damage claims. Considerable knowledge of the general theory and content of public liability negligence and…