Senior Claims Adjuster (Liability)

METRO•Houston, TX

About The Position

Responsible for investigating and administering assigned Liability claims and when warranted pursue litigation and subrogation against third parties. Performs duties in a safe, efficient manner and in compliance with applicable rules and safety procedures.

Requirements

High school diploma or GED is required.
Minimum five (5) years of progressively responsible liability claims and litigation claims management experience.
Excellent analytical skills in researching and reviewing negligence laws, traffic codes, accident reports, statements or interrogatories, medical bills, indexes and medical narratives.
Good communications (written and verbal) skills.
Must have an understanding of legal insurance defense, medical terminology, and functional knowledge of Texas Tort Claims Act and/or Texas Workers’ Compensation Act.
Texas Insurance Adjusters license in one of these types: Texas Property and Casualty or a Texas All Lines license is required.

Nice To Haves

Bachelor’s degree in Risk Management, Finance or Business Administration is preferred.
Bilingual preferred.

Responsibilities

Investigates and administers liability claims of varying complexity including, bodily injury, first party auto, third party auto, first party property, and general liability.
Sets appropriate financial reserves and maintains adequate funding.
Sets appropriate diary date schedule according to claim milestones.
Takes recorded statements from involved parties and explains the Texas Tort Claims Act and procedures as needed.
Requests indexing of all injured parties through Insurance Services Office (ISO) and confirms eligibility for benefits through Centers for Medicaid & Medicare Services (CMS).
Requests damage appraisals, police reports, medical bills, medical reports and wage information.
Reviews facts, establishes liability, evaluates damages and negotiates appropriate settlements within the authority granted based upon all known facts.
Reports suspected fraudulent claim activities to the appropriate law enforcement agency, NICB or counsel for METRO.
Maintains contact with all parties regarding claims (i.e., repair vendors, appraisal vendors, doctors, claimants, and attorneys).
Coordinates investigation with Workers’ Compensation adjusters to avoid duplication of processes and subrogation pursuit.
May be required to represent METRO at mediations, depositions, pretrial hearings and other legal proceedings as deemed appropriate.
Provides any additional information requested by supervisors or lawyers relating to claims.
Reviews claim files on a daily diary basis and pursues subrogation.
Provides excellent customer service to METRO internal and external customers.
Applies Safety Management System (SMS) methods and principles in daily routine and supports all aspects of the agency’s Public Transportation Agency Safety Plan (PTASP).
Promotes safety awareness and follows safety procedures to reduce or eliminate accidents.
Performs other job-related duties as assigned.