Sr Claims Specialist

Metra•Chicago, IL

9d•Hybrid

About The Position

The Sr. Claims Specialist will work with a third-party administrator (TPA) to investigate and assess agency liability for personal injury, work related incidents covered under Federal Employers' Liability Act (FELA), and property claims; provide the agency's defense counsel with documentation and administrative support pertaining to interrogatories and production requests; and comply with federal reporting requirements. The primary duties include: Coordinate the collection of information and evidence from various departments to set up claims and provide TPAs with information required to access liability exposure, set appropriate claim reserves based on liability evaluation, severity of injuries and likely extent of damages, assess risk transfer potential, and tender appropriate claims to third parties for further handling and agency indemnification. Conduct investigations and perform other activities to assess the agency's liability and exposure to FELA, personal injury, and property damage claims; obtain internal documents, claimant and witness statements; photograph accident sites; and measure and canvass the incident areas. Review medical reports to track and record medical bill payments. Coordinate with TPA to assist in the negotiation and resolution of open liability claims. Provide documentation and administrative support to Metra's defense counsel pertaining to interrogatories and production requests. Coordinate team’s day-to-day activities, assign tasks/projects and monitor performance, and provide guidance and training, but is not a supervisor. Promote safe work practices and maintain and foster a safe work environment. Generally, works indoors but may at times be required to work outdoors during investigations and may be exposed to some severe weather conditions. Perform other related duties as assigned to meet the ongoing needs of the organization. Metra is a railroad employer subject to the provisions of the Railroad Retirement Tax Act, not the Social Security Administration.

Requirements

Bachelor's degree from an accredited college or university or in lieu of a degree, any combination of education and experience may be substituted for the degree that equals four (4) years in claims management.
Must have five (5) years of claims management experience processing workers compensation, FELA, property and casualty, or personal injury claims.
Working knowledge of principals, practices, and procedures related to risk management, FELA, general liability, property damage, and subrogation.
Working knowledge of litigation techniques.
Working knowledge of government agencies (i.e., Federal Railroad Administration (FRA), RRB, and Centers for Medicare & Medicaid Services); regulations (e.g. Medicare Secondary Payer rule and the State Children's Health Insurance Program (SCHIP) Extension Act of 2007), and their record-keeping and reporting requirements.
Working knowledge of investigation techniques including evidence and admissibility.
Working knowledge of on-line investigation sites to locate claimants and property.
Working knowledge of Illinois and Cook County Civil Procedure and Illinois Personal Injury laws.
Proficient in Microsoft 365 (Word, Exel, Access) and working knowledge of various claims management programs.
Strong analytical, organization, and problem solving skills with attention to details.
Strong written and verbal communication and negotiation skills.
Ability to conduct in-depth investigations and witness interviews.
Ability to prepare detailed, accurate, and objective investigative reports.
Ability to establish and working relationships with internal and external stakeholders such as TPAs, outside counsel, and host railroad carriers.
Ability to write settlement authority memorandum and briefs.
Ability to maintain confidentiality.
Must possess and maintain a driver's license.
Ability to stand, walk, and/or sit, for extended periods of time.
Must be able to operate a vehicle.
Must be willing to travel within and outside of Metra’s 6-county region.
Must be available on-call 24-hours/day, 7 days/week, 365 days/year, including weekends and holidays.

Responsibilities

Coordinate the collection of information and evidence from various departments to set up claims and provide TPAs with information required to access liability exposure, set appropriate claim reserves based on liability evaluation, severity of injuries and likely extent of damages, assess risk transfer potential, and tender appropriate claims to third parties for further handling and agency indemnification.
Conduct investigations and perform other activities to assess the agency's liability and exposure to FELA, personal injury, and property damage claims; obtain internal documents, claimant and witness statements; photograph accident sites; and measure and canvass the incident areas.
Review medical reports to track and record medical bill payments.
Coordinate with TPA to assist in the negotiation and resolution of open liability claims.
Provide documentation and administrative support to Metra's defense counsel pertaining to interrogatories and production requests.
Coordinate team’s day-to-day activities, assign tasks/projects and monitor performance, and provide guidance and training, but is not a supervisor.
Promote safe work practices and maintain and foster a safe work environment.
Perform other related duties as assigned to meet the ongoing needs of the organization.