RISK MANAGEMENT PROGRAM SPECIALIST - 43001344

State of Florida•JACKSONVILLE, FL

6d•$52,000 - $55,000•Onsite

About The Position

This position conducts investigations into State liability claims which are filed against the State and its employees. When necessary, assign specific claims to contract adjusters for field investigation. 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. Conducts investigations into State liability claims, which are filed against the State and its employees. When necessary, assign specific claims to contract adjusters for field investigation. Responsible for supervising and directing the contract adjuster’s activity during the investigation process and responsible for the overall quality of claims management. Responsible for the continual review of claims files. Directly 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.

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.
Knowledge 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.
Maintains overall quality of claims management.
Continually reviews claims files.
Manages all facets of litigation, including scrutinizing legal documents to discern legal strategies.
Maintains a fundamental working knowledge of applicable statutory, case law, and procedural laws.
Suggests strategies to attorneys for efficient and professional handling of assigned claims.
Assists the agency involved in coordinating with the defense attorney.
Develops an agreed plan of defense with the contract defense attorney.
Keeps the Administrator and personnel of the involved state agency informed of significant case developments.
Authorizes timely offers of judgment/proposals for settlement, offers of settlement, and pre-trial settlements.
Attends court ordered mediations and trials.
Applies appropriate case law and makes a determination of liability for settlement exploration.
Evaluates medical reports, vendor bills, and estimates of damage.
Authorizes and makes offers of settlement up to approved authority and denies claims when necessary.
Adjusts and records claim reserve and reserve balances to reflect monetary exposure.
Reviews, adjusts, and approves all attorney and other contract vendors' fees and expense statements.
Maintains the accuracy of claims information and reserves in the division's data processing system.
Ensures proper data coding into the system and accurate verification.
Maintains the file diary system.