Claims Specialist

San Diego Metropolitan Transit System (MTS)•San Diego, CA

7h•$65,822 - $93,468

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 Specialist maintains claim files, assigns case numbers, and enters information into SAP and the MTS claims database. The role adjusts property damage claims and assists with non-represented bodily injury claims, processes and follows up on subrogation demands, prepares reports and spreadsheets, and processes purchase requisitions and invoices for the Risk & Claims Department. The position also supports workers’ compensation activities, responds to inquiries and claims, prepares presentations, schedules meetings, and serves as a backup contact for designated claims staff and as a backup Agency representative for small claims court actions. Work is performed primarily in an office environment and may involve travel to external locations and agencies. The successful candidate must be able to meet the stated physical demands and may occasionally work more than eight hours per day or an irregular work week.

Requirements

At least three years of experience in liability, subrogation, and/or workers’ compensation claims administration, as well as general administrative support experience.
Associate’s or bachelor’s degree from an accredited college or university in risk management or a related field; relevant knowledge, skills, and abilities may substitute for the degree requirement.
Knowledge of, or ability to learn, MTS policies and regulations, and ability to understand and apply policies, regulations, and union labor contracts.
Ability to write clear, concise, grammatically correct letters, memoranda, and reports.
Ability to communicate clearly and effectively in person-to-person and small-group situations, using tact and diplomacy.
Ability to coordinate and initiate actions to implement decisions and delegate responsibilities appropriately.
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.
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 the life-of-claim handling process.
Ability to present information effectively and respond to questions from groups, managers, customers, and the general public.
Ability to represent MTS positively when 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 and comprehensive criminal background and credit checks, and a pre-employment drug test when applicable.
Must be able 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 proficiency in English and Spanish is preferred but not required.

Responsibilities

Adjusts property damage claims from start to finish and assists the Liability Claims Supervisor with bodily injury claims.
Assigns case numbers and establishes claim files.
Maintains and updates documented claim files and the database of liability claims, incidents, and related activities.
Receives inquiries, incidents, and claims from the public and internal staff by telephone and electronic media.
Creates and maintains Excel spreadsheets and reports for liability and workers’ compensation data for management, underwriters, actuaries, auditors, quarterly claim reviews, and performance incentive plan results.
Generates quarterly reports for the General Counsel and Manager of Risk & Claims on Agency-wide legal fees, costs, and liability claim payouts.
Creates purchase requisitions and processes invoices for payment for the Risk & Claims Department.
Ensures correspondence and reports meet deadlines and that distributed information is accurate and complete.
Schedules meetings, checks participant availability, reserves facilities, and prepares meeting venues with necessary equipment and documents.
Acts as backup contact for the Liability Claims Supervisor.
Acts as backup Agency representative for small claims court actions.
Acts as backup contact for the Workers’ Compensation Analyst and assists with related tasks and projects.
Prepares PowerPoint presentations for internal and external audiences.
Maintains, archives, stores, and destroys claim files in accordance with local, state, and federal requirements.
Performs other duties as assigned.