RISK MANAGEMENT PROGRAM SPECIALIST - 43001085

State of Florida•Tampa, FL

6d•$52,000 - $55,000•Onsite

About The Position

This position conducts investigations into State liability claims filed against the State and its employees. When necessary, specific claims are assigned to contract adjusters for field investigation. The role involves negotiating and settling claims filed against the state and its employees, and working with assigned counsel to resolve and defend claims brought against the state and employees. The specialist is responsible for supervising and directing the contract adjuster’s activity during the investigation process and for the overall quality of claims management. This includes the continual review of claims files, litigation management, scrutinizing legal documents, discerning legal strategies, and suggesting strategies to attorneys. The role also involves developing defense plans with contract defense attorneys, keeping agency personnel informed of case developments, authorizing settlements, and attending mediations and trials. Based on investigation and discovery, the specialist applies case law to determine liability, evaluates damages, authorizes settlements, and adjusts claim reserves. The role also includes reviewing and approving vendor fees and expenses, and maintaining the accuracy of claims information in the division's data processing system.

Requirements

High school diploma or equivalent required.
Proficient in using Microsoft Word and Excel.
Must be able to travel Statewide by flying or driving a car.
Knowledge of the principles of insurance & risk management; of methods of compiling, organizing, & analyzing data.
Ability to conduct fact-finding interviews.
Ability to investigate insurance claims.
Ability to understand and apply applicable rules, regulations, policies and procedures.
Ability to collect, analyze and interpret data.
Ability to make and defend decisions about insurance claims.
Ability to plan, organize & coordinate work activities.
Ability to communicate effectively verbally & in writing.
Ability to establish & maintain an effective working relationship with others.

Nice To Haves

One (1) or more years of experience in the insurance field or adjusting liability claims.
Experience in the legal field or working with attorneys.
Experience in negotiations or conflict resolution.
Experience working in a Risk Management Information System, Insurance Management system, or similar claims database.
Currently have or have held a Florida Adjuster license.
Bachelor’s degree from an accredited college or university.

Responsibilities

Conducts investigations into State liability claims which are filed against the State and its employees.
Assign specific claims to contract adjusters for field investigation when necessary.
Negotiates and settles claims filed against the state and our employees.
Works with assigned counsel to resolve and defend claims brought against the state and employees.
Supervises and directs the contract adjuster’s activity during the investigation process.
Responsible for the overall quality of claims management.
Responsible for the continual review of claims files.
Responsible for all facets of litigation management include scrutinizing summons and complaints, answers, motions, and other legal documents to discern legal strategies, possible additional claims and counter claims, etc.
Responsible for having and maintaining a fundamental working knowledge of the statutory, case law, and procedural laws applicable to assigned cases and for suggesting to attorney’s other strategies pertinent to the efficient and professional handling of each assigned claim.
Responsible for assisting the agency involved, where appropriate, in coordinating with the defense attorney.
Responsible for developing, with the contract defense attorney, an agreed plan of defense.
Responsible for keeping the Administrator and personnel of the involved state agency fully informed of significant case developments.
Responsible for authorizing timely offers of judgment/proposals for settlement, offers of settlement, pre-trial settlements, and for attending court ordered mediations and trials.
Based on facts derived from the claims investigation and or pre-trial discovery, responsible for applying appropriate case law and making a determination of liability for the purpose of exploring the desirability of settlement; related to this responsibility is the need to properly evaluate medical reports, vendor bills, and estimates of damage; responsible for authorizing and making offers of settlement up to approved authority and denying claims when necessary.
Responsible for the adjustment and recording of claim reserve and reserve balances to reflect the monetary exposure on claim files.
Responsible for the review, adjustment, and approval of all attorney and other contract vendors' fees and expense statements, including all travel and other expenses of vendors.
Responsible for the overall maintenance of the claims information contained in the assigned claim files, including the accuracy of the claims information and reserves in the division's data processing system.
This includes proper data coding into the system and accurate verification.
Responsibility also includes the effective maintenance of the file diary system.