Risk Management-Claims Administrator - Property and Casualty Program Assignment

Job Summary

Reporting directly to the Director of Risk Management, responsible for administering Williamson County's claims management program and performing the duties necessary for the successful adjudication of claims on behalf of the County. Participates in planning of programs, policies, and objectives for work group and department.

Workers' Compensation Program Assignment

• Administers the investigation, documentation, and reporting of claims to third party administrator (TPA) and County Officials; interviews claimants, employees, doctors, medical specialists, or other witnesses for pertinent information of occurrence
• Provides direct oversight activity supervising the administration of workers' compensation claims by third party claims administrator
• Requests and approves assignment of ancillary services including Nurse Case Management, Utilization Review, work hardening, vocational rehabilitation, or surveillance assignment
• Directly supervises TPA and outside counsel efforts on claim administration, claim payments, subrogation efforts, and settlement negotiations
• Collaborates with Risk Analyst on monthly claims reporting and claims status to departments and County Officials
• Monitors TPA's performance and compliance with their contract, ensures TPA compliance in reporting claims to insurance broker and carriers in accordance with reporting requirements, and participates in periodic audits of TPA
• Participates in internal audits as required by the County Auditor
• Ensures compliance with all Federal, State, and Local regulations and statutes regarding the filing of any state mandated forms, e.g., first reports of injury, supplemental report of injury, subsequent required work status reports, and wage statements
• Monitors claims for statute of limitations and coordinates with in-house and outside counsel for litigation of claims, assisting with investigation and documentation; attends workers' compensation hearings on behalf of the County to assist outside counsel as needed, providing evidence and reporting progress of hearing to appropriate County Officials
• Partners with Loss Control Administrator in the management of the County's Temporary Transitional Assignment program (TTA) for early return to work of injured workers; coordinates communication and organization with injured worker, supervisor, doctors, and TPA adjuster; provides training and communicates with the department personnel to encourage participation and coordination of efforts for success of program
• Coordinates with Loss Control Administrator and Risk Analyst in identifying common claim trends, unsafe practices, and other employee risk exposures
• Participates in the development and upkeep of departmental policies and procedures
• Assists departments in timecard management regarding workers' compensation leave
• Reports to Human Resources any claims involving employee noncompliance with department supervisor or Risk Management directives
• Works together with Human Resources on workers' compensation claims that also involve the FMLA
• Provides employee outreach and education regarding work safety
• Provides departmental training on the workers' compensation program
• Creates and oversees implementation of the service instructions and claims handling procedures for the TPA
• Utilizes claims management software
• Creates and maintains the department's record keeping system
• Attends and participates in all meetings and trainings, as required
• Serves as backup to other Risk Claims Administrators
• Assists the Risk Manager on all aspects of program development under this assignment
• Performs other duties as assigned

Property and Casualty Program Assignment

• Directly handles all aspects of property damage claims, including coordination with Facilities and the involved department on damage assessments and repairs, communicates with the County's carrier and broker, and processing of claim payments
• Directly handles all aspects of auto property damage claims (non-liability), including submitting claims to other party's carrier, processing of claim payments, and coordination with Fleet Services and the involved department on damage assessments and repairs
• Administers the investigation, documentation, and reporting of claims to third party administrator (TPA) and County Officials; gathers information from claimants, employees, doctors, medical specialists, or other witnesses for pertinent information of occurrence
• Provides direct oversight activity supervising the administration of auto and general liability claims by third party administrator
• Requests and approves assignment of ancillary claim services as needed
• Directly supervises TPA on claim administration, claim payments, subrogation efforts, and settlement negotiations
• Collaborates with Risk Analyst on monthly claims reporting and claims status to departments and County Officials
• Monitors TPA's performance and compliance with their contract, ensures TPA compliance in reporting claims to insurance broker and carriers in accordance…