Claims Examiner

Location
Washington D.C.
Posted
Jan 20, 2017
Closes
May 02, 2017
Function
Other
Hours
Full Time
Job Description
Job Title: Claims Examiner
Job ID: 170045 Location: DC -Jackson Graham Bldg-8th Fl
Posting Open-Close 01/19/2017
- 02/02/2017
Full/Part Time: Full-Time
Union NRP
Regular/Temporary: Regular Job Description

Position/Posting Details:

All WMATA  posted job openings are available through 11:59 pm the night before the noted Close Date. To ensure successful submission of application applicants are encouraged to apply well before this cut-off.  The noted Close Date is the date on which the posting is automatically removed from the website as of 12:00am at which time submission of an application is no longer possible. (WMATA reserves the right to remove postings at any time without notice as business needs demand.)

Department Marketing Statement:

Third Party Liability-Claims Examiner

The ideal candidate selected for this position will support the TPL Manager through innovative leadership and technical claim oversight as follows:

  • Supervise technical and/or administrative employees as assigned by the TPL Manager
  • Handling complex, high visibility claims as needed
  • Serves as lead liaison with the Office of General Counsel for all claims in litigation, including weekly litigation meetings on new items
  • Develop and deliver relevant training sessions to enhance technical claim handling skills for the team
  • Conduct internal quality control audits to measure performance against standards

Minimum Qualifications:

Graduation from an accredited college or university with a Bachelor's Degree in Business Administration, Accounting, Finance, Risk Management or other related field. Six (6) years of progressively responsible experience in Third Party Claims or insurance adjusting including: two (2) years varied casualty claims handling experience within either the insurance or self-insurance industries both as an Inside and Outside Adjuster; two (2) years experience supervising casualty claims; and one (1) year experience using standard personal computer applications (e.g., word processing, spreadsheet, database and graphics), windows applications and a risk management information system. Candidate must be able to be immediately bonded.

Experience in lieu of education will be considered if candidate can demonstrate progressively responsible experience in Third Party Claims or insurance adjusting; experience within either the insurance or self-insurance industries both as an Inside and Outside Adjuster; two (2) years experience supervising casualty claims; and one (1) year experience using standard personal computer applications (e.g., word processing, spreadsheet, database and graphics), windows applications and a risk management information system. Candidate must be able to be immediately bonded.

License:

Possession of a valid motor vehicle operator's license from the jurisdiction of residence.

Medical Group:

Satisfactorily complete the medical examination for this position, if required.  The incumbent must be able to perform the essential functions of this position either with or without reasonable accommodations.

Job Summary/Duties:

This position is responsible for superv1s1on and professional/technical claims oversight, monitoring, evaluation, and liaison work, as prioritized by the Manager, Third Party Claims. This position directly supervises technical (claims adjusters) and administrative (claim assistant, claim technician, receptionist) employees as designated by the Third Party Claims (TPC) Manager. The incumbent provides technical guidance to the staff of Claims Adjusters in order to promote proactive determinations of liability and damage evaluations, along with disposition plans to close claims. The incumbent may serve in an acting capacity for the Managers during absences.

Develops, monitors and updates technical guidelines for reserving claims, claims handling, investigation and statistics. Assists the TPC Manager in developing, updating and managing all technical and administrative TPC claim processes.

Supervises subordinate staff to include recommending applicant selection,disciplinary actions, resolution of grievances, assigning duties, directing and evaluating work, conducting performance appraisals, approving leave requests and time sheets, and ensuring appropriate subordinate training is provided. Conducts performance appraisals for assigned staff and performs administrative personnel duties for his/her assigned subordinate staff.

Maintains statistical and reserve accuracy and credibility in the Risk Management Information System (RMIS) utilized by the Authority. Generates Risk Management reports from the RMIS.

Accountable to the WC and TPC Managers and to the Director of Risk Management for both data accuracy and the credibility of reports written from the RMIS.

Interviews assigned staff to organize and track requirements and movement on individual's designated career path.

Develops, updates and maintains technical training programs for new and experienced Claims Adjusters and administrative employees.

Negotiates and settles large exposure type claims, writing or supervising structures settlement programs when necessary.

Assists Managers in overall administration of claims in accordance with the TPC Claims Manual. Along with the TPC Manager, authors and publishers revisions of the Claims Manual.

The above duties and responsibilities are not intended to determine specific duties and responsibilities of any particular position. It is not intended to limit in any way the right of supervisors to assign, direct and control the work of employees under their supervision.

Evaluation Criteria:

Consideration will be given to applicants whose resumes demonstrate the required education and experience. Applicants should include all relevant education and work experience.

Evaluation criteria may include one or more of the following:

  • Personal Interview
  • Skills Assessments
  • Verification of education and experience
  • Criminal Background Check
  • Credit history report for positions with fiduciary responsibilities
  • Successful completion of a medical examination including a drug and alcohol screening
  • Review of a current Motor Vehicle Report

Closing:

Washington Metropolitan Area Transit Authority, a Federal contractor, is an Equal Opportunity / Affirmative Action employer.  All qualified applicants receive consideration for employment without regard to race, color, creed, religion, national origin, sex, gender, gender identity, age, sexual orientation, genetic information, physical or mental disability, or status as a protected veteran, or any other status protected by applicable federal law, except where a bona fide occupational qualification exists.  Our hiring process is designed to be accessible and free from discrimination.

This posting is an announcement of a vacant position under recruitment.  It is not intended to replace the official job description.  Job Descriptions are available upon confirmation of an interview.