Job Description

The Claims Specialist investigates, evaluates, and resolves claims in compliance with laws and policies, while at the Tier 2 Claims Specialist level handles complex cases, litigation, and stakeholder management.

Salary

$56,451 - $ 62,500

Ideal Candidate

The ideal candidate for this exciting role in a dynamic team environment should possess a bachelor’s degree and have over five years of experience in adjusting liability claims. A Florida 620 adjuster's license is required, as it demonstrates the necessary expertise and commitment to excellence in the field. This individual should be a proactive problem solver with strong communication & organizational skills, and able to thrive in a collaborative setting while delivering exceptional results.

• Bachelor's Degree
• Possess five plus years of adjusting commercial automobile and liability claims.
• Florida 620 adjusters license is required.

Core Competencies

• Customer Commitment - Proactively seeks to understand the needs of the customers and provide the highest standards of service.
• Dedication to Professionalism and Integrity - Demonstrates and promotes fair, honest, professional and ethical behaviors that establishes trust throughout the organization and with the public we serve.
• Organizational Excellence - Takes ownership for excellence through one's personal effectiveness and dedication to the continuous improvement of our operations.
• Success through Teamwork - Collaborates and builds partnerships through trust and the open exchange of diverse ideas and perspectives to achieve organizational goals.

Tier 2

Duties and Responsibilities

Note: The following duties are illustrative and not exhaustive. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. Depending on assigned area of responsibility, incumbents in the position may perform some or all the activities described below.

• Conduct comprehensive investigations of losses using appropriate techniques, including interviews, recorded statements, documentation and data gathering, and securing/preserving evidence.
• Verify, analyze, and accurately apply coverage in accordance with County policies and applicable laws.
• Develop strategies for claim resolution and negotiate settlements to achieve timely conclusions.
• Determine the appropriate outcome of claims (e.g., pay, deny, compromise) based on analysis of facts, liability, and statutory/case law.
• Assess the need for and provide directions to third-party administrators (TPA), legal counsel, or other technical experts.
• Monitor and control claims costs to ensure cost-effective outcomes.
• Evaluate liability and damages, identifying subrogation, salvage, or fraud/suspicious claim opportunities.
• Prepare timely, accurate, and concise reports as required.
• Promptly establish and maintain accurate reserves throughout the life of the claim.
• Performs other related duties as required.

Job Specifications

• Ability to adjust complex Commercial Automobile and Liability claims to proper conclusion, including handling complex litigation and coverage issues.
• Demonstrated proficiency in interviewing, problem solving, communication (verbal and written), and time management and conflict resolution skills.
• Must be service oriented with the ability to work in a team environment, collaborate with others and build strong customer relationships.
• Ability to apply computer applications and use related software.
• Knowledge of statutes, case law and standardized practices, regulations and ordinances applicable to multi-line claims administration.
• Knowledge of insurance principles, procedures, government self-insurance programs and industry practices.
• Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Understands the implications of new information for both current and future problem-solving and decision-making
• Ability to communicate with internal and external customers -- represents the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail.

Physical Requirements

• Position is typically in an office environment.
• Requires an employee to be mostly sedentary.
• This position may occasionally require travel to field sites to conduct job-related inspections, investigations, or other duties.

Work Category

• Light Work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg control requires exertion of forces greater than that of sedentary work and if the worker sits most of the time, the job is considered light work.

Minimum Qualifications Required

• Graduation from an accredited four-year college or university in a related field of work; AND
• Two (2) years of experience directly related to the duties listed above.

• Three (3) plus years of adjusting complex Commercial Automobile and Liability claims to proper conclusion, including handling complex litigation and coverage issues preferred.

  OR

• An equivalent combination of education, training and experience that would reasonably be expected to provide the job-related competencies noted below. (For education and experience only, does not include legally required Licenses or Certifications.); AND
• 620 Independent Adjuster license or equivalent (must be able to renew and self-appoint every two years).

Additional Requirements for some positions

Emergency Management Responsibilities

In the event of an emergency or disaster, an employee may be required to respond promptly to duties and responsibilities as assigned by the employee’s department, the County’s Office of Emergency Management, or County Administration. Such assignments may be for before, during or after the emergency/disaster.

Career Progression

Employees in this classification that acquire the competencies and minimum qualifications for the next tier will be able to apply for promotional opportunities through a competitive selection process. Employees will not automatically be upgraded to the next tier. Reclassifying a position is based on business need and financial impact and is not based solely on the job competencies or qualifications of the incumbent.