HR Class Specs
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9/20/2013 10:13:29 AM
6/27/2012 4:52:11 PM
HR Class Specs
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HR Class Specs Department
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<br /> <br /> CLAIMS ADJUSTER <br /> <br /> <br /> Classification #: 022 <br /> FLSA: Exempt <br />EEOC: 02 <br /> <br /> <br /> <br /> <br />GENERAL STATEMENT OF DUTIES <br />: <br /> <br />Provides administration, coordination, processing, and monitoring of workers’ compensation, <br />property damage, bodily injury, and liability claims. Performs a variety of professional and <br />technical claims management duties in support of the risk management division. Performs other <br />related duties as assigned. <br /> <br />SUPERVISION RECEIVED <br />: <br /> <br />Works under the general supervision of the risk manager or assigned designee, who may assign <br />and review work for conformance to established policies. <br /> <br />SUPERVISION EXERCISED <br />: <br /> <br />Supervision of other employees is not a function of positions in this classification. <br /> <br />EXAMPLES OF DUTIES <br />: (Duties may include, but are not limited to the following.) <br /> <br />1. Investigates claims by means of physical inspection, taking statements, securing <br />necessary reports, and reviewing data; interfaces with third party administrator, defense <br />counsel, experts, and investigators; composes and distributes appropriate forms and <br />correspondence; prepares field notes and reports; establishes and modifies claim reserves; <br />negotiates settlement of claims within assigned settlement authority. <br /> <br />2. Determines liability of county and third parties to apportion damages and adjust claims; <br />follows claims adjusting practices, including determining extent of injuries and damages, <br />assessing credibility of participants, and verifying time/wage loss claims. <br /> <br />3. Coordinates with departments to promote early return-to-work for injured workers; <br />monitors modified duty work assignments; maintains required documents and processes <br />reimbursement requests from Employer-at-Injury Program; consults with physicians and <br />rehabilitation professionals to identify physical limitations/restrictions. <br /> <br />4. Provides day-to-day guidance to workers’ compensation third party administrator; <br />monitors compliance with state auditing requirements; identifies and pursues potential <br />cost recovery from third parties. <br /> <br />5. Maintains data related to injuries, accidents and claims; analyzes and interprets data to <br />produce performance reports and provide information to managers for use in prevention <br />activities; prepares OSHA injury logs and annual reports. <br /> <br /> <br /> <br />
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