Risk Management-Claims Administrator

THIS IS AN INTERNAL OPPORTUNITY FOR CURRENT WILLIAMSON COUNTY EMPLOYEES ONLY

Reporting 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.

Workers’ Compensation Program Assignment

• Administers 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 occurrence
• Provides direct oversight activity supervising the administration of workers’ compensation claims by third party claims administrator
• Requests and approves assignment of ancillary services including Nurse Case Management, Utilization Review, work hardening, vocational rehabilitation, or surveillance assignment
• Directly supervises TPA and outside counsel efforts on claim administration, claim payments, subrogation efforts, and settlement negotiations
• Collaborates with Risk Analyst on monthly claims reporting and claims status to departments and County Officials
• Monitors 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 TPA
• Participates in internal audits as required by the County Auditor
• Ensures 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 statements
• Monitors 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 Officials
• Partners 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 program
• Coordinates with Loss Control Administrator and Risk Analyst in identifying common claim trends, unsafe practices, and other employee risk exposures
• Participates in the development and upkeep of departmental policies and procedures
• Assists departments in timecard management regarding workers’ compensation leave
• Reports to Human Resources any claims involving employee noncompliance with department supervisor or Risk Management directives
• Works together with Human Resources on workers’ compensation claims that also involve the FMLA
• Provides employee outreach and education regarding work safety
• Provides departmental training on the workers’ compensation program
• Creates and oversees implementation of the service instructions and claims handling procedures for the TPA
• Utilizes claims management software
• Creates and maintains the department’s record keeping system
• Attends and participates in all meetings and trainings, as required
• Serves as backup to other Risk Claims Administrators
• Assists the Risk Manager on all aspects of program development under this assignment
• Performs other duties as assigned

ORGANIZATION RELATIONSHIPS

• Reports directly to – Director of Risk Management
• Direct Reports – No

PHYSICAL DEMANDS

• Position involves prolonged sitting at a workstation, visual examination of documents, reaching, walking, twisting, bending, standing and occasional lifting/carrying

ENVIRONMENTAL FACTORS

• Work is primarily indoors in an air-conditioned environment
• Regular travel between work sites as required

IRREGULAR HOURS

• Work outside of the normal office hours (Monday-Friday 8 a.m. to 5 p.m.) may be required
• May be deemed essential personnel in the event of an emergency
• Regular attendance is required

The 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.

• Bachelor’s degree in a related field and two (2) years of related insurance experience; OR an equivalent combination of education and experience
• Working knowledge of specific job-related technology

LICENSES AND CERTIFICATIONS

Required

• None

PREFERRED QUALIFICATIONS

• Bachelor’s degree in a related field
• Three (3) years of claims handling experience
• Risk Management certification

EMPLOYMENT TESTING

Employment is contingent on passing any post-offer pre-employment screening as listed below:

• Criminal background check: Yes
• Motor Vehicle Record check: Yes
• Drug screening: No
• Physical exam: No
• Psychological exam: No
• Additional: N/A

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 POLICY

Williamson 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.