Risk Management-Claims Administrator

JOB
THIS IS AN INTERNAL OPPORTUNITY FOR CURRENT WILLIAMSON COUNTY EMPLOYEES ONLYReporting directly to the Director of Risk Management, responsible for administering Williamson County’s claims management program and performing the duties necessary for the successful adjudication of claims on behalf of the County. Participates in planning of programs, policies, and objectives for work group and department.

EXAMPLE OF DUTIES
Workers’ Compensation Program AssignmentAdministers the investigation, documentation, and reporting of claims to third party administrator (TPA) and County Officials; interviews claimants, employees, doctors, medical specialists, or other witnesses for pertinent information of occurrenceProvides direct oversight activity supervising the administration of workers’ compensation claims by third party claims administratorRequests and approves assignment of ancillary services including Nurse Case Management, Utilization Review, work hardening, vocational rehabilitation, or surveillance assignmentDirectly supervises TPA and outside counsel efforts on claim administration, claim payments, subrogation efforts, and settlement negotiationsCollaborates with Risk Analyst on monthly claims reporting and claims status to departments and County OfficialsMonitors TPA’s performance and compliance with their contract, ensures TPA compliance in reporting claims to insurance broker and carriers in accordance with reporting requirements, and participates in periodic audits of TPAParticipates in internal audits as required by the County AuditorEnsures compliance with all Federal, State, and Local regulations and statutes regarding the filing of any state mandated forms, e.g., first reports of injury, supplemental report of injury, subsequent required work status reports, and wage statementsMonitors claims for statute of limitations and coordinates with in-house and outside counsel for litigation of claims, assisting with investigation and documentation; attends workers’ compensation hearings on behalf of the County to assist outside counsel as needed, providing evidence and reporting progress of hearing to appropriate County OfficialsPartners with Loss Control Administrator in the management of the County’s Temporary Transitional Assignment program (TTA) for early return to work of injured workers; coordinates communication and organization with injured worker, supervisor, doctors, and TPA adjuster; provides training and communicates with the department personnel to encourage participation and coordination of efforts for success of programCoordinates with Loss Control Administrator and Risk Analyst in identifying common claim trends, unsafe practices, and other employee risk exposuresParticipates in the development and upkeep of departmental policies and procedures Assists departments in timecard management regarding workers’ compensation leaveReports to Human Resources any claims involving employee noncompliance with department supervisor or Risk Management directivesWorks together with Human Resources on workers’ compensation claims that also involve the FMLAProvides employee outreach and education regarding work safetyProvides departmental training on the workers’ compensation programCreates and oversees implementation of the service instructions and claims handling procedures for the TPAUtilizes claims management softwareCreates and maintains the department’s record keeping systemAttends and participates in all meetings and trainings, as requiredServes as backup to other Risk Claims Administrators Assists the Risk Manager on all aspects of program development under this assignmentPerforms other duties as assignedProperty and Casualty Program AssignmentDirectly handles all aspects of property damage claims, including coordination with Facilities and the involved department on damage assessments and repairs, communicates with the County’s carrier and broker, and processing of claim paymentsDirectly handles all aspects of auto property damage claims (non-liability), including submitting claims to other party’s carrier, processing of claim payments, and coordination with Fleet Services and the involved department on damage assessments and repairsAdministers the investigation, documentation, and reporting of claims to third party administrator (TPA) and County Officials; gathers information from claimants, employees, doctors, medical specialists, or other witnesses for pertinent information of occurrence Provides direct oversight activity supervising the administration of auto and general liability claims by third party administrator Requests and approves assignment of ancillary claim services as neededDirectly supervises TPA on claim administration, claim payments, subrogation efforts, and settlement negotiationsCollaborates with Risk Analyst on monthly claims reporting and claims status to departments and County OfficialsMonitors TPA’s performance and compliance with their contract, ensures TPA compliance in reporting claims to insurance broker and carriers in accordance with reporting requirements, and participates in periodic audits of TPAParticipates in internal audits as required by the County AuditorGathers all information, documents/recordings, and statements regarding claim incidents for purposes of fact finding and liability determination Coordinates with Loss Control Administrator on post-claim investigations as neededMonitors claims for statute of limitations and assists in-house and outside counsel on additional claim investigation, claim denials, litigation, and requests from outside counsel, as needed Submits restitution claims, including all requested documentation, to the County Attorney’s Office or District Attorney’s Office on criminal cases involving damage to county propertyCoordinates with Loss Control Administrator and Risk Analyst in identifying common claim trends, unsafe practices, and other county risk exposuresParticipates in the development and upkeep of departmental policies and proceduresProvides employee outreach and education regarding incident reportingProvides departmental training on the property and casualty programsCreates and oversees implementation of the service instructions and claims handling procedures for the TPAUtilizes claims management softwareCreates and maintains the department’s record keeping system Attends and participates in all meetings and trainings, as requiredServes as backup to other Risk Claims Administrators Assists the Risk Manager on all aspects of program development under this assignmentPerforms other duties as assignedORGANIZATION RELATIONSHIPSReports directly to – Director of Risk ManagementDirect Reports – NoPHYSICAL DEMANDSPosition involves prolonged sitting at a workstation, visual examination of documents, reaching, walking, twisting, bending, standing and occasional lifting/carryingENVIRONMENTAL FACTORSWork is primarily indoors in an air-conditioned environmentRegular travel between work sites as requiredIRREGULAR HOURSWork outside of the normal office hours (Monday-Friday 8 a.m. to 5 p.m.) may be requiredMay be deemed essential personnel in the event of an emergencyRegular attendance is requiredThe above statements are intended to describe the general nature and level of work being performed by individuals assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required of personnel so classified in this position. This job description is subject to change as the needs and requirements of the job change.

SUPPLEMENTAL INFORMATION
A Williamson County online application (resumes alone are not sufficient) must be received before the position is closed. Positions are open until filled, subject to close at any time after five (5) calendar days. The Human Resources Department is located at 100 Wilco Way, Georgetown, TX 78626. Phone (512) 943-1533 or visit our website at www.wilcotx.gov/469/Human-Resources. Williamson County is an Equal Opportunity Employer and complies with the Americans with Disabilities Act and Uniformed Services Employment and Reemployment Rights Act (USERRA). If you require an accommodation in order to apply for a position, please request assistance from the Human Resources Department.TOBACCO FREE WORKPLACE POLICYWilliamson County is a tobacco free workplace. The use of tobacco products (e.g., cigarettes, cigars, pipes, snuff, chew, etc.) and Electronic Nicotine Delivery Systems (ENDS) (e.g., vapor, e-cigarettes, etc.) is prohibited on all Williamson County premises. Employees who violate this policy are subject to appropriate disciplinary action up to and including termination of employment.