Claims Specialist

San Diego Metropolitan Transit System•San Diego, CA

About The Position

The Claims Specialist completes complex tasks and projects for the Liability Claims Supervisor, Workers’ Compensation Analyst, and Manager of Risk & Claims. Under the direction of the Liability Claims Supervisor, the role maintains and updates claim files, assigns case numbers, and enters data into SAP and the MTS claims database. The specialist adjusts property damage claims and assists with non-represented bodily injury claims, processes and follows up on subrogation demands, prepares reports and spreadsheets, and handles purchase requisitions and invoices for the Risk & Claims Department. The position also receives inquiries and claims from the public and internal staff, supports workers’ compensation activities, schedules meetings, prepares presentations, and serves as a backup contact for the Liability Claims Supervisor and Workers’ Compensation Analyst. Claim files must be maintained, archived, stored, and destroyed in accordance with applicable local, state, and federal requirements. Work is performed primarily in an office environment and may require travel to external locations and agencies. More than eight hours per day or an irregular work week may occasionally be required.

Requirements

Associate’s or bachelor’s degree from an accredited college or university in risk management or a related field, or relevant knowledge, skills, and abilities substituted for the degree requirement.
At least three years of experience in liability, subrogation, and/or workers’ compensation claims administration, along with general administrative support experience.
Knowledge of, or ability to learn, MTS policies and regulations and the ability to read, understand, and apply MTS policies, regulations, and union labor contracts.
Ability to write clear, concise, grammatically correct letters, memoranda, and reports, and to communicate effectively with individuals and small groups using tact and diplomacy.
Ability to coordinate and initiate actions necessary to implement decisions and delegate responsibilities to appropriate personnel.
Ability to prioritize and complete assignments by deadlines without detailed instructions.
Skill in verifying the accuracy and completeness of forms and reports.
Knowledge of Microsoft Word, Excel, and ERP (SAP) systems, and ability to learn and use other software used or acquired by MTS.
Ability to exercise discretion and independent judgment within claims management guidelines and applicable government codes and regulations.
Ability to make sound decisions consistent with MTS values, behaviors, policies, and procedures.
Ability to prepare relevant information for claims adjusting, mediation, and litigation.
Some knowledge of liability claims adjustment principles and claim life-cycle handling processes.
Ability to present information effectively and respond to questions from groups, managers, customers, and the public.
Ability to represent MTS positively while working with the public.
Must possess and maintain a valid California Driver License or be able to use alternative transportation when needed for essential job functions.
Must satisfactorily pass applicable post-offer examinations, including a pre-employment physical, criminal background and credit check, and, when applicable, a pre-employment drug test.
Ability to walk, stoop, sit, bend, reach for overhead files, occasionally lift up to 15 pounds, operate a motor vehicle, and perform manual-dexterity tasks such as computer and 10-key use.

Nice To Haves

Public agency experience is preferred but not required.
Bilingual in English and Spanish is preferred but not required.

Responsibilities

Adjust property damage claims from start to finish and assist the Liability Claims Supervisor with bodily injury claims.
Assign case numbers, establish claim files, and maintain comprehensive, well-documented files and liability claims databases.
Receive inquiries, incidents, and claims from the public and internal staff by telephone and electronic media.
Create and maintain Excel spreadsheets and reports covering liability and workers’ compensation data for management, underwriters, actuaries, auditors, claim review meetings, and performance incentive plan results.
Prepare quarterly reports for the General Counsel and Manager of Risk & Claims on agency-wide legal fees, costs, and liability claim payouts.
Create purchase requisitions and process invoices for the Risk & Claims Department.
Ensure correspondence and reports meet deadlines and that distributed information is accurate and complete.
Schedule meetings, coordinate participant availability, reserve facilities, and prepare meeting venues and materials.
Serve as a backup contact for the Liability Claims Supervisor and Workers’ Compensation Analyst, and assist the analyst with tasks and projects.
Serve as a backup Agency representative for small claims court actions.
Prepare PowerPoint presentations for internal and external audiences.
Maintain, archive, store, and destroy claim files in accordance with local, state, and federal requirements.
Perform other duties as assigned.