Claims Specialist Ii

Location
Fairfax, Virginia
Salary
$60,276.11 - $100,461.09 Annually
Posted
Sep 11, 2021
Closes
Sep 24, 2021
Ref
21-01827
Function
Administrative
Industry
Insurance
Hours
Full Time
Job Announcement

Handles automobile liability, bodily injury, general liability, subrogation and first party property damage claims for Fairfax County Government's in-house claims management program. Investigates and determines liability, completes onsite investigations and substantiates all aspects of each claim. Works closely with the County Attorney on claims in litigation. As a member of the Risk Management Division's team, participates in strategic planning and establishment of program goals and objectives. Provides training to county agencies and employees on claims related matters. Works closely with the county’s third party administrator on workers’ compensation claims. Reports directly to the Claims Manager.

Position may be underfilled as a Claim Specialist I; the underfill requirements are stated below in the Employment Standards section.

Note: Salary offer will not exceed the mid-point of the salary range $80,368.91.

Illustrative Duties

(The illustrative duties listed in this specification are representative of the class but are not an all inclusive list. A complete list of position duties and unique physical requirements can be found in the position description.)
  • Reviews all claim recommendations;
  • Performs analysis and adjusting of special claims and complaints;
  • Monitors and reports on production and quality assurance (audits);
  • Monitors internal/external customer service claim questions/concerns;
  • Provides oversight and direction for the care of seriously injured employees;
  • Administers procedures for reserving, recording and analyzing claims;
  • Provides technical direction to Claims Specialists;
  • Oversees the claims workflow;
  • Provides oversight of the rehabilitation process and maintains effective working relationship with agencies to expedite the return of disabled employees covered by workers' compensation to maximum function.


Required Knowledge Skills and Abilities

(The knowledge, skills and abilities listed in this specification are representative of the class but are not an all inclusive list.)
  • Knowledge of the mission, goals, and objectives of claims management;
  • Knowledge of the principles, practices and techniques relating to claims management;
  • Ability to perform a variety of increasingly complex work in areas relating to claims management;
  • Ability to identify possible solutions for solving business problems;
  • Ability to communicate effectively orally and in writing;
  • Ability to use word processing, spreadsheet, and presentation software to prepare documents and to store, manipulate, analyze and present information;
  • Ability to train and supervise staff.


Employment Standards

MINIMUM QUALIFICATIONS:
Any combination of education, experience, and training equivalent to the following:
(Click on the aforementioned link to learn how Fairfax County interprets equivalencies for “Any combination, experience, and training equivalent to”)
Graduation from an accredited four-year college or university with a bachelor's degree in the field related to insurance, claims management, finance, business administration, or other related field; plus two years of complex claims professional work experience.

CERTIFICATES AND LICENSES REQUIRED:

Possession of a valid motor vehicle driver's license.

UNDERFILL REQUIREMENTS:
This vacancy may be underfilled at the level of Claims Specialist I (S21, $52,323.44 - $87,205.04). The employment standards for the Claims Specialist I are:
  • Any combination of education, experience, and training equivalent to the following: Graduation from an accredited four-year college or university with a bachelor's degree in a field related to insurance, financial management, business administration or claims management;
    or
  • BRIDGE CLASS EMPLOYMENT STANDARDS: Four years of increasingly complex technical experience in the assigned functional area, comparable to experience at the Admin Assistant IV, or higher, level.
    • Claims Specialist I class can serve as a bridge class enabling individuals who do not meet the educational or professional experience standards listed above to qualify for this class by possessing four years of increasingly complex technical experience in the assigned functional area, comparable to experience at the Admin Assistant IV, or higher, level. The purpose of this bridge class is to promote upward mobility within the Fairfax County workforce. However persons qualifying for this class on the basis of their technical experience may not substitute this technical experience for education, or for professional experience, in order to qualify for other employment opportunities.
Click here to view the complete details and KSAs for the Claims Specialist I. Upon completion of an underfill agreement (which will require that the employee meet the employment standards for a Claims Specialist II in addition to obtaining competencies and licensures defined by the hiring agency) the employee will be elevated to the level of Claims Specialist II. The timeframe to fulfill the underfill agreement is normally one year but may be up to two years. Personnel who cannot meet the requirements of the higher level position within two years will not be certified as an underfill.

NECESSARY SPECIAL REQUIREMENTS:

The appointee to this position will be required to complete a criminal background, credit, and a driving record check to the satisfaction of the employer.

This position is emergency/essential services personnel. (Required to report for duty during inclement weather and/or other emergencies).

All newly hired employees are required to be fully vaccinated as a condition of employment or obtain approval of a medical or religious exemption prior to their start date. Proof of an exemption or vaccination status will be required during the pre-employment onboarding process. New employees who obtain an exemption from the vaccine mandate for medical or religious reasons will still be subject to the weekly testing requirement. Otherwise, vaccinated employees will complete the attestation online in the first day of employment.

PREFERRED QUALIFICATIONS:
  • Designation and/or an Associate in Claims (AIC) Designation.
  • Knowledge of Virginia Workers' Compensation and tort liability laws.
  • Strong knowledge of claims investigation techniques.
  • Strong analytical and problem solving skills.
  • Excellent oral and written communication skills.
  • Strong customer service experience.
  • Ability to multi-task, manage priorities and adapt to a fluid work environment.
  • Multi-Line claim handling experience.

PHYSICAL REQUIREMENTS:
Job is generally sedentary in nature. However, visual acuity is required to read data on computer monitor. Ability to operate keyboard drive equipment, motorized vehicle and carry items up to 15 lbs. All duties performed with or without reasonable accommodations.

SELECTION PROCEDURE:
Panel Interview and may include a practical exercise.

Fairfax County Government prohibits discrimination on the basis of race, color, religion, national origin, sex, pregnancy, childbirth or related medical conditions, age, marital status, disability, sexual orientation, gender identity, genetics, political affiliation, or status as a veteran in the recruitment, selection, and hiring of its workforce.

Reasonable accommodations are available to persons with disabilities during application and/or interview processes per the Americans with Disabilities Act. Contact 703-324-4900 for assistance. TTY 703-222-7314. EEO/AA/TTY.