Job Description

General Liability Claims Adjuster needed for Risk Management Group handling self-insured claims. Located in Folsom, California!

• HOURS: 8 am – 4:30 pm
• DURATION: This is a temporary position to start.
• WORKPLACE: In-office to start.
• PAY: Hourly pay depends on experience, $38.00/hr. - $42.00/hr.
• BENEFITS: Weekly payroll, direct deposit, online time entry, sick leave pay, and upon meeting eligibility: holiday pay, vacation pay and 401K Retirement Plan.

Job Duties May Include, But Are Not Limited To

Will be responsible for managing a caseload of simple to complex cases within the GL1 and GL2 programs. Caseload management requires monitoring and evaluating member claim files, reserves and coverage; collaborating with third party administrators (TPAs) and self-administered members with regard to settlement or defense of their claim files; updating file records; presenting claims to the Claims Review Committees; and creating and maintaining open and constructive channels of verbal and written communication with all members, TPAs, defense counsel, and reinsurers/excess carriers.

• Maintain diary to document updates, correspondence, and strategies towards resolution on a 200+ pending claims caseload.
• Monitor and evaluate case strategy, litigation management, reserves and case statuses to ensure compliance with applicable Addendum B Standards.
• Make decisions regarding coverage for lesser complex exposures and generate coverage related correspondence.
• Engage coverage counsel on complex exposures as needed.
• Present claims to the appropriate committees for settlement authority or coverage determination.
• Update information concerning claims and maintain claims files within the claims system, including documentation of analysis of the exposure and plan of action, file material in electronic environment, and appropriate claims fields in the system to maintain data integrity.
• Generate requisite reports from claims files.
• Contact member agencies, TPAs, defense counsel or reinsurers/excess carriers concerning claims status and information.
• Create and maintain positive, collaborative relationships with members, committees, and staff.
• Actively participate in committee meetings as necessary.
• Attend mediations/MSCs as needed.
• There will be a moderate amount of travel.
• Perform other duties as assigned.

Requirements

The ideal candidate will have a Bachelor’s Degree in directly related field or equivalent and five years increasingly responsible work in directly related field; or, an equivalent combination of education and experience sufficient to successfully perform the essential duties of the job, including but not limited to:

• Strong working knowledge in Microsoft Office including Word and Excel.
• Experience working with a RMIS system (SIMS, iVOS, Valley Oaks, etc.)
• Ability to set priorities and handle multiple projects simultaneously.
• Ability to handle basic arithmetical calculations.
• Good presentation skills.
• Ability to conduct research, analyze and interpret information.
• Ability to establish and maintain effective working relationships and good public relations with other employees, agencies, members, and the public.
• Knowledge of applicable laws and regulations.
• Knowledge of research and evaluation techniques.
• Completion of specialized educational training and courses related to insurance claims adjusting, reporting, settlement, and management are highly desirable.
• Public agency claims experience is highly desirable.

Physical Requirements

Physical requirements of this position typically include: reaching, grasping, talking, hearing, seeing, repetitive motions, exerting up to 20 pounds of force occasionally and/or up to 10 pounds of force frequently, and/or negligible amount of force constantly to move.

Some travel may be required.

• Regular and consistent attendance as defined per Company policy.
• Work is performed in a typical interior/office work environment.
• Ability to use computer keyboard and sit in a stationary position for extended periods as well as the use of office equipment such as fax and copy machines, and telephones.
• May be required to stand for extended periods of time.
• Must possess effective communication and listening skills such that complicated information can be communicated in a straight forward manner that the listener can understand, as well as paraphrasing and questioning to gain a complete understanding of the speakers concerns and goals.
• Ability to prioritize, multi-task, set goals and meet deadlines.
• Must be a team player that possesses strong customer service and problem solving skills.
• Must have a professional demeanor, be detail oriented, organized, highly ethical and have a positive attitude.

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