Risk Management Analyst
Category: Classified
Pay Grade: C24
Job Code: 15820
To perform this job successfully, an individual must be able to perform the essential job functions satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the primary job functions herein described. Since every duty associated with this position may not be described herein, employees may be required to perform duties not specifically spelled out in the job description, but which may be reasonably considered to be incidental in the performing of their duties just as though they were actually written out in this job description.
JOB SUMMARY
Performs technical and administrative work to support and assist with claims processing for all lines of insurance coverage; assists in the planning, coordination, monitoring, and participates in analysis and investigation within the standardized practices for claims administration; provides technical and administrative support to department supervisors and claims adjusters for continuous claims processing, subrogation recovery, payment requests, data management, and customer service. Performs professional and highly technical work related to the analysis and administration of the workers’ compensation insurance program of the County, including working with our Third-Party Administrator (TPA).
ESSENTIAL JOB FUNCTIONS (examples, not all inclusive)
- Provides assistance in planning, organizing, and collecting data and information for multi-line claims;
- Provides assistance to County departments and inter-departmental staff to ensure compliance with statutory regulations and County policies/procedures;
- Assists supervisors and claims adjusters in the analysis and investigation, assembles risk management case files and documents requiring knowledge of statutory regulations, and assists in coordination of defense preparation with senior staff members;
- Performs data processing related duties including using available statistical packages or multi-function software, encoding data, and routine computer terminal operations;
- Maintains frequent contact with citizens, employees, appraisers, and insurance company representatives relating to status of condition and progress and requests and reviews supporting documentation (often highly confidential in nature) to effectively assist in recovery or resolution;
- Attends meetings;
- Processes indemnity payments, bills, etc;
- Receives, reviews and tracks workers’ compensation notifications from TPA, Davies Company;
- Analyzes data for accuracy and coordinates information between TPA and our employees;
- Provides technical expertise and guidance to County employees and TPA;
- Maintains communication with County departments and discusses gap issues;
- Attends departmental meetings in regard to workers’ compensation matters;
- Performs other related job duties as assigned.
QUALIFICATIONS
Education and Experience:
Four (4) years of clerical experience in claims administration, or related work in a loss control program; or an Associate’s degree in finance, business, accounting, public administration, or related field plus one (1) year of claims or insurance policies or procedures related experience; or an equivalent combination of education, training, and/or experience.
Special Qualifications (May be required depending on area of assignment):
- Florida Driver’s License or Florida Commercial Driver’s License and endorsement, if any.
- Assignment to work a variety of work schedules including compulsory work periods in special, emergency, and/or disaster situations.
- Other knowledge, skills, abilities, and credentials required for a specific position.
Knowledge, Skills and Abilities:
- Knowledge of statutes, standardized practices, regulations, and County policies applicable to multi-line claims administration and workers’ compensation;
- Knowledge of administrative claims processing techniques, principles, procedures and/or practices, and government self-insurance programs;
- Knowledge of standard office software applications such as word processing, spreadsheets, email, Internet access, and data processes;
- Knowledge of business English, spelling, arithmetic, and bookkeeping standards;
- Ability to operate a personal computer and apply basic software applications;
- Ability to deal with the public and employees with tact and diplomacy in resolving stressful or conflicting situations;
- Ability to communicate clearly and concisely orally and in writing;
- Ability to maintain and retrieve statistical and factual reports and provide appropriate assistance.
PHYSICAL/MENTAL DEMANDS
This work requires exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Additionally, the following physical abilities are required:
- Visual ability: Sufficient to effectively operate office equipment including copier, computer, etc.; and to read and write reports, correspondence, instructions, etc.
- Hearing ability: Sufficient to hold a conversation with other individuals both in person and over a telephone; and to hear recording on transcription device.
- Speaking ability: Sufficient to communicate effectively with other individuals in person and over a telephone.
- Mental acuity: Ability to make rational decisions through sound logic and deductive processes.
- Talking: Expressing or exchanging ideas by means of the spoken word including those activities in which they must convey detailed or important spoken instructions to other workers accurately, loudly, or quickly.
- Walking: Moving about on foot to accomplish tasks, particularly for long distances or moving from one work site to another.
WORKING CONDITIONS
Work is performed in a relatively safe, secure, and stable work environment.