Claims Program Supervisor - (US-CA-Riverside - 92522)

Minimum Education: None
Job Type: Full Time
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Responsibilities : Supervises the activities and day-to-day operations of workers' compensation insurance claims section ; assigns, evaluates and supervises the investigation and adjusting of all claims by staff; monitors adjusting techniques; approves recommended settlement value within authorized monetary authority. Receives, reviews, accepts or denies claims; evaluates medical reports and reports of experts to determine liability and damages; evaluates merit of claims and estimates anticipated settlement value. Coordinates litigation cases and in-service training with outside defense attorneys, appropriate department heads and County Counsel staff; reviews and prepares cases for legal defense or appeal before appeals boards and related adjudicating bodies; secures documentary evidence of births, deaths, marriages and divorces in fatality cases. Develops and maintains claims records and computer record keeping systems; assures accuracy conformance to policies and procedures and accessibility of claims records. Hires and evaluates subordinate staff; trains staff in department/agency practices, policies and procedures; participates in the discipline of subordinates. Maintains liaison with other counties, cities, insurance companies and legal firms on matters relating to claims against the county. Analyzes legislation, court decisions, industry trends and claims costs to recommend changes in procedures and policies to reduce the County's liability exposure. Confers with outside claims adjusters and defense attorneys regarding contract rates; drafts and contract and related Board agenda items.

Requirements :Bachelor's degree from an accredited college or university in Business or Public Administration or a related field. Experience:A minimum of five years journey or higher level experience in the direct administration, or management of, workers' compensation claims including reviewing, evaluating and investigating highly complex cases involving fraudulent or subrogation claims. Candidates must have achieved the level of Experienced Claims Adjuster (as defined by California Code of Regulations, Title 10, Chapter 5, Subchapter 3) defined as possessing one of the following: 1) Working 5 out of the last 8 years as a California Worker Comp Claims Adjuster, 2) Has worked continuously in California adjusting claims since passing the Self-Insurance Test, or 3) Has passed the Self-Insurance test in the last 2 years.

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