Claims Manager

Job Description:

Claims Manager

Description

Requirements

MOS Codes: None

Education and Experience : Bachelor’s Degree or higher in Business or Public Administration, Finance, Risk Management, Insurance, or a related field, and four (4) years of professional experience administering workers’ compensation, property and casualty insurance claims, self-insurance, or captive insurance programs, including two (2) years of supervisory experience.

Licenses and Certificates : Valid Texas Class "C" Driver's License or equivalent from another state by time of appointment. Workers’ Compensation Adjustor’s license is required within one (1) year of appointment. Property & Casualty Adjuster License required within one (1) year of appointment. Associate in Risk Management from the Insurance Institute of America and/or Certified Claims Examiner Certification from the State of Texas is preferred.

General Purpose

Under the direction, manages the City of El Paso insurance programs including workers’ compensation, property/casualty, and subrogation/recovery claims.

Typical Duties

Identify, assess, and mitigate risks associated with human, physical, and liability claims. Involves: Administer and coordinate claims processing and implement strategies to prevent, control, and/or transfer risks through claims management processes and procedures, self-insurance, commercial insurance, and /or other financial instruments. Coordinate with internal business partners to establish a framework and methodology to mitigate reported incurred and/or incurred but not yet reported losses. Manage all claims, with varying degrees of complexity, to full and successful resolution.

Manage and administer non-tort claims and seek recovery of damages. Involves: Administer medical/case management, claims strategy, negotiation, and adjudication of claims within the level of authority. Initiate and monitor claims investigations, and accept or deny claims. Monitor and ensure the accuracy of claims financial data maintained in the Risk Management Information System (RMIS). Set financial reserves for claims and conduct periodic internal reserve audits. Represent the City of El Paso at settlement conferences, hearings, arbitrations, mediations, and trials. Negotiate settlements on behalf of the City within the limits of authority. Administer the return-to-work/transitional duty program for injured workers. Manage third-party administrator processes on workers’ compensation claims. Provide all tort notices to the City Attorney’s Office upon receipt.

Claims administration: Involves: Establishing processes, policy, and priorities, developing and implementing procedures on claims processing and maintenance of claims data, program integrity, and controls. Conduct periodic claims reviews and management meetings with departments, third-party claims examiners/adjusters, and City Attorney’s Office. Advise supervisor on annual claims program budget needs. Communicate claims management philosophy, case strategy, and financial implications to management. Review and finalize workers’ compensation regulatory reports and ensure compliance with reporting requirements. Maintain current knowledge of changes to workers’ compensation, property/casualty, and subrogation/recovery statutes, and act as an in-house resource for departments. Provide education and training to employees on claims matters, especially workers’ compensation response and policies/procedures. Manage and coordinate recoverable claims to successfully subrogate and facilitate insurance recoveries. Assist with Total-Cost-of-Risk analysis, insurance, and self-insured cost forecasting, and data analysis including reviewing and providing input on data trends and variances. Serve on special project teams and assignments.

Supervise assigned staff. Involves: Assign, schedule, guide, and monitor work. Appraise employee performance and review subordinate supervisors' appraisals. Provide for training and development. Counsel, motivate, and maintain harmony. Identify and resolve staff differences, conflicts, and deficiencies. Interview applicants. Recommend hiring, discipline, termination, promotion, or other employee status changes. Enforce personnel rules and regulations and work behavior standards firmly and impartially.

General Information

For complete job specification, click here .

Note: Applicants are encouraged to apply immediately. This position will close when a preset number of qualified applications have been received.

Important Note: The required Supplemental Questions and answers are considered an examination component and will generate a score.


Applicants are being tested on a conditional basis pending a review of minimum qualifications. Applications will be reviewed for applicants who pass the Supplemental Questions exam.

Per CSC Rules & Regulations, after review of the minimum qualifications for applicants that pass the Supplemental Questions exam, a passing score, combined with applicable seniority points and veteran points, will be used to create a list of candidates.

Note: Applicants with foreign diplomas, transcripts and degrees must have all documents translated and evaluated by an agency of the National Association of Credential Evaluation Services (NACES) prior to submitting them to the Human Resources Department. Please visit www.naces.org/members for more information.

A résumé and/or other documents will not be accepted in lieu of a completed application. Comments such as “See résumé” are not acceptable and will result in the application being considered incomplete.

To qualify for this position, the required education, experience, knowledge, and skills must be clearly stated on your application’s employment history. We do not use any information on your resume to review if you meet the minimum qualifications for this position.

Failure to fully detail all experience and job duties in the application, or copying/pasting directly from the job specification, or responses referring to your résumé will eliminate you from consideration for the position.

BENEFITS

LIFE AND HEALTH INSURANCE

The City of El Paso is a self-insured entity with a third-party administrator for Medical and Pharmacy benefits. Basic Life Insurance Coverage is available at no cost to eligible employees. Additional Life Insurance and coverage for your dependents are also available.

Employees can select optional Dental, Vision, and Short Term Disability coverage. Employees also have the option to participate in a Health Savings Account or Flexible Spending Account (healthcare and/or dependent care for daycare expenses). All of these insurance and coverage options can be configured within a month of your new employee orientation date.

An Employee Assistance Program (EAP) with access to mental health sessions, therapy, and more is available at no cost. A trained counselors are also available to help you and your dependents cope with life’s stressors so that you can live a happy productive lifestyle.

The City’s Wellness Program seeks to promote better health and wellness amongst the workforce through various programs and incentives in which employees may choose to participate in, to include wellness education, fitness tests, biometric screenings, group fitness, health coaching and so much more!

Keep Learning, Growing & Reinventing Yourself! The City of El Paso's Tuition Assistance Program encourages employee personal and professional development by sharing educational costs with those employees who have successfully completed their original probation, and in turn retain a skillful workforce. Each year, employees can obtain Tuition Assistance for Degree, Certifications, Continuing Education, and Books & Equipment.

ELIGIBILITY FOR VACATION LEAVE

All regular employees who are regularly scheduled to work on an average, a minimum of twenty (20) hours per week, who have held a position in the City Service for a period of six months from date of employment, shall be eligible for vacation allowance as hereinafter set forth. Part-time employees shall accrue vacation leave at a pro-rated amount of full-time entitlement based on the number of hours that they are scheduled to work. Employees covered by collective bargaining agreements shall accrue vacation as provided in the applicable agreement.

Regular employees in the City Service shall accrue vacation credit at the following rates per pay period, calculated from the date of employment of each employee:

For 0 - 5 years of service (12 days):
40 hour per week employees - 3.70 hours per biweekly pay period

For >5 to 15 years of service (17 days):
40 hour per week employees - 5.24 hours per biweekly pay period

For >15 or more years of service (20 days):
40 hour per week employees - 6.16 hours per biweekly pay period

SICK LEAVE WITH PAY

Employees shall be entitled to accrue sick leave with pay in accordance with the Rules of the Civil Service Commission.

ACCIDENT WITH PAY LEAVE

The Amended Section 4.4 of the Ordinance shall become effective upon adoption and shall apply to occupational injuries and occupational diseases occurring on and after date of adoption. Occupational injuries and occupational diseases occurring before such date will be governed by the Ordinance in effect at the time of the date of injury or disease.

PREGNANCY LEAVE

A) Pregnancy shall be treated the same as any other temporary physical disability.

B) An employee on pregnancy leave shall use accumulated and unused regular sick leave time and then (unless granted use of special sick leave) shall be on leave without pay, unless the employee chooses to use any accumulated and unused annual leave.

C) An employee going on pregnancy leave shall give written notice to her department head with appropriate medical verification. Before returning to work from pregnancy leave, the individual will provide appropriate medical documentation releasing the employee to return to work, as is required for any individual who has been on leave for a temporary physical disability.

LEGAL HOLIDAYS

The following days are hereby declared legal holidays for all the City departments, provided that the provisions of this section shall not apply to members of the Fire Department whose duties are to prevent or extinguish fires, or to members of the Police Department whose duties are those of law enforcement: (Amended 10/03/95)

1. First day of January (New Year's Day)

2. Third Monday in January (Martin Luther King Holiday)

3. Thirty-first day in March (Cesar Chavez Day)

4. Last Monday in May (Memorial Day)

5. June 19 (Juneteenth)

6. Fourth day of July (Independence Day)

7. First Monday in September (Labor Day)

8. Eleventh Day in November (Veteran's Day)

9. Fourth Thursday in November (Thanksgiving Day)

10. The Friday following the fourth Thursday in November (Day after Thanksgiving)

11. Twenty-fifth Day in December (Christmas Day)

12. Employee's Birthday

In addition to the above days, the following days are also declared to be legal holidays: 1. Any day designated as a holiday by City Council. 2. When any legal holiday falls on a Saturday, the preceding Friday shall be considered a legal holiday. 3. When any legal holiday falls on a Sunday, the following business day shall be considered a legal holiday.

Closing Date/Time: Continuous

Salary:

$76,593.71 - $114,890.57 Annually