Senior Claims Adjuster - Workers' Compensation

San Antonio Water System • San Antonio, TX, United States • $200k - $250k / year • 3w ago

Grade 21 - Starting Annual Salary: $77,799.00. Rate of pay depends on qualifications. JOB SUMMARY

The Senior Claims Adjuster is responsible for providing a broad knowledge of Workers' Compensation. In addition to property, and casualty claims expertise by investigating, valuating, reserving, negotiating, and settling complex claims in accordance with best claims practices and complies with all City, State, Federal regulatory laws. This position promptly and equitably resolves claims to minimize SAWS’ liability and reduce overall claims cost.

ESSENTIAL FUNCTIONS

Oversees all Workers' Compensation Claims.
Conducts field investigations and evaluates complex claims to include vehicle accidents, workers’ compensation injuries, liability, and third-party contractor damages.
Sets reserves to accurately reflect cost of claim.
Issues payments in a timely manner to claimants and vendors in accordance with all regulatory standards and laws.
Communicates effectively, both written and orally, with internal and external customers including employees, executives, attorneys, medical professionals, governmental officials, contractors, and law enforcement personnel.
Assists legal in litigated claims including attendance in legal meetings, proceedings and hearings, assists in answering legal documentation, and provides responses to legal interrogatories.
Preserves evidence by using diagrams, photographs, video, written/recorded statements, email, medical reports, preparing appraisals, and other technical means.
Researches historical evidence through work orders, maps, microfiche, e-mails, statements, medical diagnosis documents, and other means as necessary to include information of a confidential nature.
Determines the value and extent of related damages and/or personal injuries by verifying supporting documentation.
Settles claims within settlement authority, by utilizing negotiating skills to protect SAWS assets.
Documents all claim file activities in accordance with established procedures.
Prepares claims reports for internal and external customers.
Assists with developing, training, and evaluating claims personnel.
Assists the Risk Management Director to resolve escalated customer claims issues.
Acts as an alternate for the Risk Management Director to approve all claims payments within authority levels granted by SAWS Board of Trustees.
Assists with escalated claims to resolve complex issues for team members and internal customers.
Performs other duties as assigned.

DECISION MAKING

The Senior Claims Adjuster receives limited supervision and assumes supervisory responsibilities in Risk Management Directors’ absence.

MINIMUM REQUIREMENTS

Bachelor’s Degree in Business Administration or related field from an institution recognized by a national accrediting agency.
Plus three years’ experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in Workers’ compensation. In addition to casualty (auto & property), appraising, personal injury, and subrogation claims.
State of Texas Multi–Line Claims Adjusters License as required by TIC 4101 or the ability to acquire a license within six months of hire.
Valid Class "C" Texas Driver's License consistent with SAWS Driving Policy.
Proficient in the use of Microsoft Word software.

High School Graduate or G.E.D.
Plus eight years’ progressively responsible experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in Workers’ compensation. In addition to casualty (auto & property), appraising, personal injury, and subrogation claims.
State of Texas Multi–Line Claims Adjusters License as required by TIC 4101 or the ability to acquire a license within six months of hire.
Valid Class "C" Texas Driver's License consistent with SAWS Driving Policy.
Proficient in the use of Microsoft Word software.

PREFERRED REQUIREMENTS

Master’s Degree from an institution recognized by a national accrediting agency.
Bilingual in English/ Spanish.
Ability to use spreadsheets, presentation and work order software.

JOB DIMENSIONS

Knowledge of claims databases.
Ability to communicate effectively both verbally and in writing with internal and external customers, property owners, vendors, and governmental agencies.

PHYSICAL DEMANDS AND WORKING CONDITIONS

Physical requirements include lifting up to 20 pounds occasionally. Subject to sitting for long periods of time to perform job scope. Occasionally subject to standing, walking and climbing on uneven surfaces. Requires visual acuity, speech and hearing. Working conditions are primarily in an office environment with occasional field visits with exposure to inclement weather; odors; chemicals; dust and poor ventilation. Also operates a company/personal vehicle.

May be required to work hours other than regular schedule such as days, nights, weekends, holidays, on-call and flexible work schedule.

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