San Antonio Water System
Senior Claims Adjuster - Workers' Compensation
San Antonio Water System, San Antonio, Texas, United States, 78208
Salary:
$77,799.00 - $139,291.00 Annually
Location :
San Antonio, TX
Job Type:
Full Time
Job Number:
2024-00222
Department:
Human Resources
Opening Date:
10/04/2024
Closing Date:
11/17/2024 11:59 PM Central
Grade 21 - Starting Annual Salary: $77,799.00. Rate of pay depends on qualifications.Job Description
JOB SUMMARYThe Senior Claims Adjuster is responsible for providing a broad knowledge of Workers' Compensation. In addition to property, and casualty claims expertise by investigating, valuating, reserving, negotiating, and settling complex claims in accordance with best claims practices and complies with all City, State, Federal regulatory laws. This position promptly and equitably resolves claims to minimize SAWS' liability and reduce overall claims cost.
ESSENTIAL FUNCTIONS
Oversees all Workers' Compensation Claims.Conducts field investigations and evaluates complex claims to include vehicle accidents, workers' compensation injuries, liability, and third-party contractor damages.Sets reserves to accurately reflect cost of claim.Issues payments in a timely manner to claimants and vendors in accordance with all regulatory standards and laws.Communicates effectively, both written and orally, with internal and external customers including employees, executives, attorneys, medical professionals, governmental officials, contractors, and law enforcement personnel.Assists legal in litigated claims including attendance in legal meetings, proceedings and hearings, assists in answering legal documentation, and provides responses to legal interrogatories.Preserves evidence by using diagrams, photographs, video, written/recorded statements, email, medical reports, preparing appraisals, and other technical means.Researches historical evidence through work orders, maps, microfiche, e-mails, statements, medical diagnosis documents, and other means as necessary to include information of a confidential nature.Determines the value and extent of related damages and/or personal injuries by verifying supporting documentation.Settles claims within settlement authority, by utilizing negotiating skills to protect SAWS assets.Documents all claim file activities in accordance with established procedures.Prepares claims reports for internal and external customers.Assists with developing, training, and evaluating claims personnel.Assists the Risk Management Director to resolve escalated customer claims issues.Acts as an alternate for the Risk Management Director to approve all claims payments within authority levels granted by SAWS Board of Trustees.Assists with escalated claims to resolve complex issues for team members and internal customers.Performs other duties as assigned.DECISION MAKING
The Senior Claims Adjuster receives limited supervision and assumes supervisory responsibilities in Risk Management Directors' absence.MINIMUM REQUIREMENTS
Bachelor's Degree in Business Administration or related field from an institution recognized by a national accrediting agency.Plus three years' experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in Workers' compensation. In addition to casualty (auto & property), appraising, personal injury, and subrogation claims.State of Texas Multi-Line Claims Adjusters License as required by TIC 4101 or the ability to acquire a license within six months of hire.Valid Class "C" Texas Driver's License consistent with SAWS Driving Policy.Proficient in the use of Microsoft Word software.OR
High School Graduate or G.E.D.Plus eight years' progressively responsible experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in Workers' compensation. In addition to casualty (auto & property), appraising, personal injury, and subrogation claims.State of Texas Multi-Line Claims Adjusters License as required by TIC 4101 or the ability to acquire a license within six months of hire.Valid Class "C" Texas Driver's License consistent with SAWS Driving Policy.Proficient in the use of Microsoft Word software.
PREFERRED REQUIREMENTS
Master's Degree from an institution recognized by a national accrediting agency.Bilingual in English/ Spanish.Ability to use spreadsheets, presentation and work order software.
JOB DIMENSIONS
Knowledge of claims databases.Ability to communicate effectively both verbally and in writing with internal and external customers, property owners, vendors, and governmental agencies.
PHYSICAL DEMANDS AND WORKING CONDITIONSPhysical requirements include lifting up to 20 pounds occasionally. Subject to sitting for long periods of time to perform job scope. Occasionally subject to standing, walking and climbing on uneven surfaces. Requires visual acuity, speech and hearing. Working conditions are primarily in an office environment with occasional field visits with exposure to inclement weather; odors; chemicals; dust and poor ventilation. Also operates a company/personal vehicle.
May be required to work hours other than regular schedule such as days, nights, weekends, holidays, on-call and flexible work schedule.
San Antonio Water System values the contributions of all its employees, providing them the best in compensation and benefits. The benefits package is designed to attract and retain a workforce of qualified employees who share a responsibility in providing quality water to 1 million consumers.From an affordable medical and dental plan to life-sustaining retirement and insurance plans, we offer benefits that reward employees for their commitment to a challenging career at SAWS. Employee benefits include the following:
Competitive, market-based salariesPerformance-based incentivesMedical benefitsDental benefitsLife insurancePrescription drug programVision care planTwo retirement plansDeferred compensation plans (457 plan)Disability incomePaid leave (vacation, sick, personal)Education assistance programEmployee assistance programFlexible, tax-deferred health and dependent care spending accountsWellness programsOn-Site Fitness FacilitiesCommunity service opportunitiesClick on the link for additional information regarding benefits:
01
Please select the following that best describes your education and experience for the posted position.
> High School Graduate or G.E.D. > Plus eight years' progressively responsible experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in the following claims disciplines: workers' compensation, casualty (auto & property), appraising, personal injury, and subrogation.> Bachelor's Degree in Business Administration or related field from an institution recognized by a national accrediting agency. > Plus three years' experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in the following claim disciplines: workers' compensation, casualty (auto & property), appraising, personal injury, and subrogation.I do not meet the required education and experience for this position.
02
Do you have experience handling Workers' Compensation claims?
No ExperienceYesNo
03
Do you have a State of Texas Multi-Line Claims Adjusters License as required by TIC 4101?
YesNoNo, I don't have the indicated Texas Multi-Line Claims Adjusters License, but I understand I must obtain within 6 months of hire.
04
Detail your proficiency with Microsoft Word software, specifically with the use of word processing, spreadsheet, and database, presentation software. If no experience, enter N/A.
05
Describe your experience in handling or your understanding of how to handle workers' compensation claims that involve a 1305 healthcare network? If no experience, enter N/A.
06
Describe your experience in the dispute resolution process for workers' compensation claims? If no experience, enter N/A.
07
Do you have a valid Texas driver's license? If so, what type of driver's license do you have?
Class CClass CDL - BClass CDL - AI do not have a valid driver's license.I have a valid driver's license from another state.
Required Question
$77,799.00 - $139,291.00 Annually
Location :
San Antonio, TX
Job Type:
Full Time
Job Number:
2024-00222
Department:
Human Resources
Opening Date:
10/04/2024
Closing Date:
11/17/2024 11:59 PM Central
Grade 21 - Starting Annual Salary: $77,799.00. Rate of pay depends on qualifications.Job Description
JOB SUMMARYThe Senior Claims Adjuster is responsible for providing a broad knowledge of Workers' Compensation. In addition to property, and casualty claims expertise by investigating, valuating, reserving, negotiating, and settling complex claims in accordance with best claims practices and complies with all City, State, Federal regulatory laws. This position promptly and equitably resolves claims to minimize SAWS' liability and reduce overall claims cost.
ESSENTIAL FUNCTIONS
Oversees all Workers' Compensation Claims.Conducts field investigations and evaluates complex claims to include vehicle accidents, workers' compensation injuries, liability, and third-party contractor damages.Sets reserves to accurately reflect cost of claim.Issues payments in a timely manner to claimants and vendors in accordance with all regulatory standards and laws.Communicates effectively, both written and orally, with internal and external customers including employees, executives, attorneys, medical professionals, governmental officials, contractors, and law enforcement personnel.Assists legal in litigated claims including attendance in legal meetings, proceedings and hearings, assists in answering legal documentation, and provides responses to legal interrogatories.Preserves evidence by using diagrams, photographs, video, written/recorded statements, email, medical reports, preparing appraisals, and other technical means.Researches historical evidence through work orders, maps, microfiche, e-mails, statements, medical diagnosis documents, and other means as necessary to include information of a confidential nature.Determines the value and extent of related damages and/or personal injuries by verifying supporting documentation.Settles claims within settlement authority, by utilizing negotiating skills to protect SAWS assets.Documents all claim file activities in accordance with established procedures.Prepares claims reports for internal and external customers.Assists with developing, training, and evaluating claims personnel.Assists the Risk Management Director to resolve escalated customer claims issues.Acts as an alternate for the Risk Management Director to approve all claims payments within authority levels granted by SAWS Board of Trustees.Assists with escalated claims to resolve complex issues for team members and internal customers.Performs other duties as assigned.DECISION MAKING
The Senior Claims Adjuster receives limited supervision and assumes supervisory responsibilities in Risk Management Directors' absence.MINIMUM REQUIREMENTS
Bachelor's Degree in Business Administration or related field from an institution recognized by a national accrediting agency.Plus three years' experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in Workers' compensation. In addition to casualty (auto & property), appraising, personal injury, and subrogation claims.State of Texas Multi-Line Claims Adjusters License as required by TIC 4101 or the ability to acquire a license within six months of hire.Valid Class "C" Texas Driver's License consistent with SAWS Driving Policy.Proficient in the use of Microsoft Word software.OR
High School Graduate or G.E.D.Plus eight years' progressively responsible experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in Workers' compensation. In addition to casualty (auto & property), appraising, personal injury, and subrogation claims.State of Texas Multi-Line Claims Adjusters License as required by TIC 4101 or the ability to acquire a license within six months of hire.Valid Class "C" Texas Driver's License consistent with SAWS Driving Policy.Proficient in the use of Microsoft Word software.
PREFERRED REQUIREMENTS
Master's Degree from an institution recognized by a national accrediting agency.Bilingual in English/ Spanish.Ability to use spreadsheets, presentation and work order software.
JOB DIMENSIONS
Knowledge of claims databases.Ability to communicate effectively both verbally and in writing with internal and external customers, property owners, vendors, and governmental agencies.
PHYSICAL DEMANDS AND WORKING CONDITIONSPhysical requirements include lifting up to 20 pounds occasionally. Subject to sitting for long periods of time to perform job scope. Occasionally subject to standing, walking and climbing on uneven surfaces. Requires visual acuity, speech and hearing. Working conditions are primarily in an office environment with occasional field visits with exposure to inclement weather; odors; chemicals; dust and poor ventilation. Also operates a company/personal vehicle.
May be required to work hours other than regular schedule such as days, nights, weekends, holidays, on-call and flexible work schedule.
San Antonio Water System values the contributions of all its employees, providing them the best in compensation and benefits. The benefits package is designed to attract and retain a workforce of qualified employees who share a responsibility in providing quality water to 1 million consumers.From an affordable medical and dental plan to life-sustaining retirement and insurance plans, we offer benefits that reward employees for their commitment to a challenging career at SAWS. Employee benefits include the following:
Competitive, market-based salariesPerformance-based incentivesMedical benefitsDental benefitsLife insurancePrescription drug programVision care planTwo retirement plansDeferred compensation plans (457 plan)Disability incomePaid leave (vacation, sick, personal)Education assistance programEmployee assistance programFlexible, tax-deferred health and dependent care spending accountsWellness programsOn-Site Fitness FacilitiesCommunity service opportunitiesClick on the link for additional information regarding benefits:
01
Please select the following that best describes your education and experience for the posted position.
> High School Graduate or G.E.D. > Plus eight years' progressively responsible experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in the following claims disciplines: workers' compensation, casualty (auto & property), appraising, personal injury, and subrogation.> Bachelor's Degree in Business Administration or related field from an institution recognized by a national accrediting agency. > Plus three years' experience in investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in the following claim disciplines: workers' compensation, casualty (auto & property), appraising, personal injury, and subrogation.I do not meet the required education and experience for this position.
02
Do you have experience handling Workers' Compensation claims?
No ExperienceYesNo
03
Do you have a State of Texas Multi-Line Claims Adjusters License as required by TIC 4101?
YesNoNo, I don't have the indicated Texas Multi-Line Claims Adjusters License, but I understand I must obtain within 6 months of hire.
04
Detail your proficiency with Microsoft Word software, specifically with the use of word processing, spreadsheet, and database, presentation software. If no experience, enter N/A.
05
Describe your experience in handling or your understanding of how to handle workers' compensation claims that involve a 1305 healthcare network? If no experience, enter N/A.
06
Describe your experience in the dispute resolution process for workers' compensation claims? If no experience, enter N/A.
07
Do you have a valid Texas driver's license? If so, what type of driver's license do you have?
Class CClass CDL - BClass CDL - AI do not have a valid driver's license.I have a valid driver's license from another state.
Required Question