Logo
TriMet

Liability Claims Adjuster

TriMet, Oregon City, Oregon, United States, 97045


Salary:

See Position Description

Location :

Suite 700, OR

Job Type:

Non-Union Regular Full-Time

Job Number:

24-00132

Department:

Finance (Non Union)

Division:

Risk Management

Opening Date:

07/02/2024

Closing Date:

11/22/2024 5:00 PM Pacific

Description

Under general supervision and within established guidelines, the Liability Claims Adjuster will investigate insurance claims for bodily injury and/or property loss or damages, and settle and/or compromise claims.

This role requires being in office three (3) days per week.

Ensure a commitment to safety through consistent and professional behaviors in performance of job requirements that demonstrate safety is a fundamental value that guides all aspects of our work. Perform related duties as required.

Serve as a good steward of TriMet by regularly utilizing our transit system to maintain a strong and current understanding of customers' experiences and of TriMet's product and service offerings.

Essential Functions

1. Investigate claims by means of physical inspections, taking witness' statements, securing necessary reports, etc. Complete and distribute appropriate forms and correspondence; prepare field notes and reports.

2. Determine liability of District and third parties. Establish case reserves within restricted scope.

3. Answer and direct phone calls for section. Set up and maintain claim files, maintain a claim file diary system, and manage individual claims in a timely fashion.

4. Follow claims adjusting practices, including determining extent of injuries, credibility of participants, damages, and verifying time/wage loss claims.

5. Monitor medical treatment and claimant's recovery process. Facilitate independent medical evaluations as necessary.

6. Ensure that all adjusting activity is properly documented, filed and reported. Regularly report claims activity to Manager, Workers' Comp & Liability Claims.

7. Use discretion, within designated guidelines, to proceed with claims settlement where investigation has determined TriMet responsibility; issue timely denials where no responsibility is determined; request restitution as appropriate in cases of third party responsibility.

8. Inform System Safety Programs Manager and client departments of health and safety issues that are identified through the claims administration process.

9. Assist the defense attorney with pretrial case preparation and settlement negotiations.

Position Requirements

A Bachelor's Degree is required.

A Bachelor's Degree in Business, Accounting, Finance, or related field is preferred.

Coursework in multi-line claims management and administration is desired.

Two (2) years of experience in multiline claims management are required.

Professional designations such as CPCU (Chartered Property/Casualty Underwriter) or ARM (Associate in Risk Management) are desired.

Two (2) years of total credited experience.*

Or any equivalent combination of experience and training.

*The amount of credit a candidate receives for prior years of experience is based on the relevancy of that experience to the required or preferred prerequisites of the job description. Experience is prorated based on hours worked. LRHR assigns and validates the "credited experience".

Selection Criteria

Type of Position / Grade / FLSAGrade 11, Exempt, Non-Union, Full-Time.

Salary RangeMinimum: $63,146.00Maximum: $94,720.00Salary offers will be determined by a candidate's education, training and relevant experience. Any final offer of employment will fall within the range stated above. For transparency, we choose to list the full available grade range, however, TriMet's salary administration process will ultimately determine the final salary offered.

Selection Process

Candidates will be selected based at a minimum on the result of:1. Application Review (please include: Cover Letter and Resume)2. Panel Interviews3. Reference Check

Supplemental InformationMake sure you describe in detail how your education, training and work experience fit with this role. You are encouraged to attach a resume, cover letter, training certificates and/or letters of recommendation with your application. You are permitted five attachments of less than 5MB each.

Internal applicants: Information in your personnel file will not be used in lieu of information requested on your application. Incomplete applications will not be considered.

If you are a qualified veteran and would like to apply for veterans' preference points, you will need to reflect your status on the application and attach supporting documentation at the time of application submission.

If you need accommodation under the Americans with Disabilities Act for any part of the application process, contact our Human Resources staff at 503-962-7505, or the TTY line at 7-1-1. Note that we require a minimum of two workdays' notice prior to the need for accommodation.

TriMet is an equal opportunity employer, committed to developing an organization that is reflective of and sensitive to the needs of the diverse community we serve, including veterans, the elderly, and individuals with disabilities.ADA StatementAs applied to the workplace, applicants and employees must be qualified to perform the essential functions of the job with or without reasonable accommodation. Essential functions may include required job functions performed infrequently as well as production standards related to the quality and quantity of work.

If a person with a disability could meet job qualifications with a reasonable accommodation, TriMet will work with the employee to accommodate the need. If TriMet's accommodation is effective in allowing the employee to perform the essential functions of the job, it need not be the employee's preferred accommodation.

Regular Full-Time or Limited Term Full-TimeNon-Union Employee Benefits

A regular full-time, non-union employee is an employee who works a minimum of 30 hours per week. A limited term, full-time employee must be hired for six or more months, have a predetermined ending date, and work a minimum of 30 hours per week.

Medical Plan Options

Regence Non-Union PPO 80/20

- Deductible: $300 Individual/$900 Family; Office Visit: 20%, after deductible; Out-of-Pocket Max: $2,300 Individual/$6,900 Family; Prescription Drugs: $10 Generic/$25 or 20% Formulary/50% Non-formulary. Benefits listed are for in-network, preferred providers.Regence Non-Union Health Savings Account (HSA)

- Deductible: $1,600 Individual/$3,200 Family; Office Visit: 20%, after deductible; Out-of-Pocket Max: $5,000 Individual/$10,000 Family; Prescription Drugs: 20%, after deductible. Benefits listed are for in-network, preferred providers.Kaiser Permanente EPO

- No deductible; Office Visit: $10 copay; Out-of-Pocket Max: $600 Individual/$1,200 Family; Prescription Drugs: $10 copay.All medical plans include prescription drug and vision coverage.

Dental Plan Options

Delta Dental of Oregon, provided by Moda -

Preventive Services paid at: 100%; Basic Services paid at: 80%; Major Services paid at: 50%; $2,000 max benefit per person/year; Orthodontia paid at: 50% to $3,000 lifetime max/person.Kaiser Dental

- $10 Copay; Preventive Services paid at: 100%; Basic Services paid at: 80%; Major Services paid at: 50%; $2,000 max benefit per person/year; Orthodontia paid at: 50% to $3,000 lifetime max/person.Coverage Effective Date

- Medical and dental insurance is effective first of the month following date of hire.

Waive Medical and Dental Coverage

- TriMet non-union, exempt employees who waive their medical and dental coverage through TriMet and provide proof of coverage outside of TriMet, will receive $250 per month as taxable income.

Medical and Dental Rates

- Non-union employees working 30+ hours/week pay 6% of the total monthly premium for medical and dental. Non-union employees working 20-29 hours/week pay 25% of the total monthly premium.

Medical and Dental Rates

- Non-union employees working 30+ hours/week pay 6% of the total monthly premium for medical and dental. The rates below reflect the employee's portion of the monthly premium.

Rates effective January 1, 2024Regence Non-Union 80/20 PPOEmployee: $ 46.02Employee & Spouse: $ 96.62Employee & Child(ren): $ 80.52Employee & Family: $ 128.84

Regence Non-Union HSAEmployee: $ 40.16Employee & Spouse: $ 84.34Employee & Child(ren): $ 70.28Employee & Family: $ 112.46

Non-Union HSA Employer Monthly ContributionEmployee: $ 62.50Employee & Spouse: $125.00Employee & Child(ren): $125.00Employee & Family: $125.00

Kaiser Permanente EPOEmployee: $ 43.76Employee & Spouse: $ 87.52Employee & Child(ren): $ 78.78Employee & Family: $ 131.284

Delta Dental of OregonEmployee: $ 4.16Employee & Spouse: $ 7.84Employee & Child(ren): $ 7.88Employee & Family: $ 11.84

Kaiser DentalEmployee: $ 3.96Employee & Spouse: $ 7.50Employee & Child(ren): $ 7.54Employee & Family: $ 11.30

Employee Assistance Program (EAP)TriMet employees have access to the EAP through Canopy. The EAP is a free, confidential resource available to help employees (and their household members) with life's everyday issues. It also provides many other services including, but not limited to: counseling sessions, webinars, financial coaching, home ownership program, and online access to a wealth of information and resources.

Wellness ProgramTriMet supports health and wellness through our Wellness Matters Program. Annual wellness offerings include: onsite biometric screening and flu shot clinics.

Flexible Spending Accounts

Health Care Spending Account -

Allows employees to set aside pre-tax dollars to pay for medical, vision, and dental expenses not covered by their health plan.Dependent Care Spending Account -

Allows employees to set aside pre-tax dollars to pay for dependent care expenses.Limited Flexible Spending Account

- Allows employees enrolled in the Regence HSA plan to set aside pre-tax dollars to pay for vision and dental expenses not covered by their health plan.Long-Term Disability InsuranceAvailable to eligible, non-union employees working at least 20 hours/week, 90-day waiting period, pays 60% of the employee's salary to a maximum of $10,000/month.

Life and Accidental Death & Dismemberment (AD&D) InsuranceBasic Life and Accidental Death & Dismemberment (AD&D) Insurance -

TriMet provides Basic Life and AD&D Insurance to assist employees and their families in the event of death or dismemberment.Benefit Amount:

1x annual earnings, $150,000 max

Voluntary Life and AD&D Insurance

- Employees may purchase additional life and AD&D insurance for themselves, spouse/domestic partner, and their child(ren). Employees pay the full cost for this insurance and must elect coverage for themselves in order to elect coverage for their dependents.

Employees may purchase one or more of the following voluntary coverages:Hospital Indemnity insurance

helps keep your finances on track when you are in the hospital. It pays you or a covered family member directly and you can use it to help cover costs such as copays, deductibles and living expenses.Critical Illness insurance

can help with costs from a serious illness that your medical insurance does not cover. It pays you or a covered family member a lump sum to use toward expenses like deductibles, groceries or childcare during recovery.Accident insurance

can help with costs that medical insurance does not cover if you are hurt in an accident. It pays you or a covered family member directly and you can use it toward your deductible, copay or daily expenses during recovery.

PensionDefined Contribution Plan 401(a)TriMet provides a defined contribution pension plan to non-union employees. TriMet matches the equivalent of 10 percent of a non-union employee's base pay into an investment account each pay period. The employee also has the option of contributing up to 15 percent of his/her base pay pre-tax to the account each pay period. The employee directs the investment of the employee's individual account. The employee is vested in the account after three years of service.

Deferred Compensation Plan 457A Deferred Compensation Plan Section 457 (a plan for public employees) allows the employee to build retirement savings with pre-tax dollars to supplement pension, Social Security and private investment.

S

ic

k LeaveEmployees receive 12 sick days of leave for a total of 96 hours (8 hours x 12 days) each January 1. Unused sick leave can be carried over to a maximum of 1,700 hours (212.5 days). Employees hired mid-year receive a prorated amount of sick leave for the first year hired. Upon separation, 60% of accrued sick leave is deposited into your 401(a) account up to a maximum of 1,700 hours.

HolidaysNon-Union employees have one day off with pay on each of the following holidays: New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Thanksgiving, the day following Thanksgiving, and Christmas.

Personal DaysEach regular non-union employee is allotted six (6) personal days with pay to be used within the calendar year. Employees hired mid-year receive a prorated amount of personal day for the first year hired.

Va

c

a

tionsEmployees accrue vacation eligibility for each continuous full year of service effective on the date of hire anniversary. For employee hired on or after November 15, 2012, the following schedule will apply:

Years of Service Weeks of VacationUpon employment* 3 weeksAfter 3 years 4 weeksAfter 8 years 5 weeks

*During the first year of employment with TriMet if employment is terminated the three weeks of vacation are not eligible for payout. Other than during the first year of employment, if employment is terminated, both the employee's banked vacation, and the vacation that has accrued ratably since the employee's last date of hire anniversary is eligible for payout in accordance with this policy.

F

r

e

e Transit PassAll active employees, their spouses/domestic partners, and eligible* dependents are eligible for a photo identification badge, which is honored as a bus/MAX pass on all lines of the District.*Child dependents are eligible for a free transit pass up to age 19, or age 24 if living at home and attending school full-time.

F

r

equen

t Flyer MileageFrequent flyer miles (miles flown on business or resulting from a business expense) may be applied to personal frequent flyer miles.

T

EI MembershipTriMet's corporate fitness center (TEI) is available to employees, and their spouse or eligible domestic partner, at five locations. Membership dues are only $13.00 per month for TriMet employees and an additional $6.00 per month for a spouse or eligible domestic partner.

NOTICE:

The information contained in this document is intended solely to provide general information regarding the benefits offered by TriMet. This information is subject to change at any time.Revised: 12/12/2023