Job Descriptions for Claims Staff

advertisement
PO Box J Prague Oklahoma 74864 405.567.2611 Fax 405. 567.3307
www.agrip.org
hpumford@agrip.org
2222 W. Main (Highway 62)
Job Descriptions for Claims Staff
As of January 2006
On January 04, 2006 Elizabeth Miller of County Risk Sharing Authority (Ohio) requested information on
job descriptions for claims manager, adjusters, and administrative staff job descriptions. The last two pages
of this document contains information on salary, tenure and number of claims handled. Staff reviewed
responses from members and included them as follows.
Responses
1. Janice Shirk, RN, Claims & Medical Manager, Pennsylvania Counties Risk Pool (PCoRP)
2. Lynnette L. McHenry, Assoc. General Counsel & Claims Manager,
Idaho Counties Risk Management Program (ICRMP)
3. Steve Spilde, Chief Executive Officer, North Dakota Insurance Reserve Fund (NDIRF)
4. David Kormann, Executive Director,
Missouri Public Entity Risk Management Fund (MOPERM)
5. John Smith, Claims Manager, Association County Commissioners of Georgia (ACCG)
Page 1
Page 7
Page 11
Page 29
Page 31
1. Janice Shirk, RN, Claims & Medical Manager, Pennsylvania Counties Risk Pool (PCoRP). –provided
job descriptions for Claims and Medical Manager, Insurance Programs Senior Claims
Representative, and Claims Administrative Assistant.
Claims and Medical Manager
Job Description
Job Description: Claims and Medical Manager
The Position: The Claims and Medical Manager is employed by CCAP to provide claims and medical
services to the association’s insurance and membership services boards of directors and to members of
CCAP Insurance Programs and related member service programs.
The Claims and Medical Manager is part of the management team of the CCAP Insurance Programs Office,
performs most work with nominal supervisor, and reports to the Managing Director, Insurance Programs for
general direction and work evaluation. The Claims and Medical Manager supervises the employees of the
claims unit of CCAP Insurance Programs.
The Claims and Medical Manager is in charge of the CCAP Insurance Programs staff when the Managing
Director is not available and cannot be contacted. In these instances, when a major issue or any personnel
issue needs to be decided, the Claims and Medical Manager will first consult with the CCAP Executive
Director.
Page 1 of 32
D:\533572642.doc
Job responsibilities include the selection, installation and operation of a claims management computer
system, and design of the positions and duties of the claims unit.
The Claims and Medical Manager also provides support to the general operation of CCAP, including
contribution of analyses and other background material for use in the CCAP lobbying effort, and other
similar duties.
The Claims and Medical Manager is responsible for supervision of the activities of claims personnel to
investigate, process claims, establish reserves and settle claims as authorized, and to render prompt claims
service and payment.
The Claims and Medical Manager is the main CCAP staff liaison to the PIMCC Governing Board and the
COMCARE Board, and is also involved in any other medical related member service of CCAP.
Claims and Medical Manager
Job Description
General Responsibilities: The Claims and Medical Manager general responsibilities include:

Supervision of the claim file handling of adjuster and claims supervisors to insure adherence to
claims procedures. Provides guidance on claims, proper reserving and monitors files in litigation.

Development and continued refinement of claims manual for CCAP Insurance Programs, and
training of claims staff in policies and procedures.

Participation in various contract and insurance policy negotiations.

Reviews, negotiates, investigates and settles claim files.

Management of selected workers’ compensation claims.

Management of selected property/casualty claims.

Acts as information source for the insurance programs staff, provides information to current
members, prospective members, brokers, claims administrators and others concerning regulations,
policies, coverage’s and procedures.

Development and maintenance of a system to store appropriate claims historical information.

Liaison to COMCARE Board and PIMCC Board and coordinator of services to be provided by
CCAP to these programs.

Management of the litigation performed by legal counsels for insurance program members, in
conjunction with the Insurance Programs Legal Counsel.

Liaison with outside vendors for peer review, utilization review, bill repricing, and other services.

Preparation of required reports for insurance regulators.

Preparation of reports for CCAP programs’ boards of directors and committees.
Page 2 of 32
D:\533572642.doc

Assistance with training and educational sessions for program board members and
participants.

Participation in the long range planning for CCAP insurance and member service programs.

Performance of other assignments and routine business of the association.
Qualifications:

Demonstrated knowledge, skills and abilities in workers’ compensation and property/casualty
insurance claims issues, management and analysis.

Demonstrated knowledge of the Pennsylvania Political Subdivision Tort Claims Act, and
experience with the defense of insurance claims filed against the state, counties and/or
municipalities.

Excellent oral and written communication skills, skill and experience in training others, better than
average computer skills.
Essential Physical Requirements:

The essential physical requirements of this position relate to the requirement to be able to operate
computer equipment essential to the completion of the position’s responsibilities.

Periodic travel to CCAP members, insurance agents, board and committee meetings and CCAP
workshops and conferences throughout Pennsylvania will be required.

Periodic travel outside of Pennsylvania, and potentially overseas, for renewal meetings and training
conferences.
FLSA
For purposes of the Fair Labor Standards Act this is an exempt position.
Job Description:
Insurance Programs Senior Claims Representative
The Position: The Claims Representative is employed by CCAP to provide claims administration
services to the association’s insurance programs.
The Claims Representative is part of the team of the CCAP Insurance Programs Office, performs
most work with some supervision, and reports to the Claims and Medical Manager for general
direction, settlement authority and work evaluation.
Job responsibilities include the investigation, evaluation, reserving, controlling expenses,
monitoring vendors, resolution of claims, and some litigation management.
The Claims Representative also provides support to the general operation of CCAP, including
background material for use in the CCAP lobbying effort, and other similar duties.
Page 3 of 32
D:\533572642.doc
General Responsibilities: The Claims Representative general responsibilities include; management of
workers’ compensation claims (medical only and some lost time).
Claims investigation, evaluation, and resolution.
Recognition of potential excess exposure and prompt reporting to the excess carriers and requesting
authority from the Board of Directors.
Acts in conjunction with other members of the claims department as an information source for the insurance
programs staff, provides information to current members, brokers, and others concerning coverages, claims
status and procedures.
Assistance and participation in training and educational sessions for PCoRP board members , participants
and CCAP claims personnel.
Participation in short and long range planning for the CCAP claims unit and for CCAP insurance and
member service programs.
Perform tasks as required as back up for Senior Claims Representative and/or Claims and Medical
Manager. Performance of other assignments and routine business of the association.
Qualifications : Qualifications for the Claim Representative are:
A college degree in business, insurance or related fields and 3 to 5 years experience as a workers’
compensation adjuster. Must have familiarity with computer claims management systems or Windows
based programs.
Must demonstrate a knowledge of the Pennsylvania Workers’ Compensation Act.
Good to excellent oral and written communication skills, adequate computer skills.
Essential Physical Requirements:
The essential physical requirements of this position relate to the requirement to be able to operate computer
equipment essential to the completion of the position’s responsibilities. Occasional travel to CCAP
members, board meetings, committee meetings, CCAP workshops and conferences throughout
Pennsylvania will be required.
Possible travel outside of Pennsylvania for training conferences.
FSLA
For the purposes of the Fair Labor Standards Act this is an exempt position.
Created April 1999
Job Description: Claims Administrative Assistant
The Position: The Claims Administrative Assistant is employed by CCAP to provide claims reporting
services for the association’s insurance programs.
Page 4 of 32
D:\533572642.doc
The Claims Administrative Assistant is part of the team of the CCAP Insurance Programs Office, performs
most work with normal supervision and oversight, and reports to the Claims and Medical Manager for
general direction and work evaluation.
Job responsibilities include setting up, refining and monitoring, in conjunction with
the Claims and Medical Manager, the check processing and financial components of the STARS claims
management computer program including all financial aspects of the STARS claims computer system and
the production of financial and loss reports. The Claims Administrative Assistant also inputs new claims
into the STARS system and performs other claims related work as directed, including preparation of
mailings and other clerical duties.
The Claims Administrative Assistant also provides support to the general operation of CCAP, including
specific projects assigned by the Claims and Medical Manager, and other similar duties.
General Responsibilities: The Claims Administrative Assistant’s general responsibilities include:
Printing, proofing, obtaining appropriate signatures and mailing all Pcomp, PCoRP and TPA claims
checks, in a timely manner based on the parameters established by the CCAP Claims Manual. Matching
the Eob’s with the appropriate check and the monitoring of recurring payments. Processing the deductible
billings and mailing to the broker and county. Input the deductible payments into STARS under the
appropriate claim.
Developing and printing STARS claims systems reports for internal use of CCAP insurance programs staff,
including loss information. Process and print the monthly aggregate reports. Process, print and mail the
quarterly loss runs to the counties and brokers. Set up and maintain quarterly loss run notebooks for the
entire insurance staff. Assist in the process of any adhoc reports requested by insurance staff or brokers.
Run reports for and compile the aggregate excess report.
Opening and distributing all daily mail for Pcomp and PCorp adjusters.
Providing back up phone answering for the CCAP insurance programs office.
Copying, collating, and preparing mailings to CCAP members.
Filing, correspondence and other administrative duties.
Performing other assignments and routine business of the association.
Qualifications: Qualifications for the Claims Administrative Assistant
The Claims Administrative Assistant position requires:
A high school diploma, and
1 to 3 years experience.
Must have familiarity with windows software or claims management system.
Excellent oral, written communication, organizational and computer skills.
Essential Physical Requirements:
Page 5 of 32
D:\533572642.doc
The essential physical requirements of this position relate to the requirement to be able to operate computer
equipment essential to the completion of the position’s responsibilities.
Periodic travel to board meetings, committee meetings, CCAP workshops and conferences throughout
Pennsylvania may be required.
FLSA
For the purpose of the Fair Labor Standards Act this is a nonexempt position.
Created January 2002
Revised November 2004
2. Lynnette L. McHenry, Associate General Counsel & Claims Manager, ICRMP – Provides job
descriptions for Claims Assistant, Claims Technician
ICRMP
CLAIMS ASSISTANT
Reports To:
Claims Manager
Supervises:
Non-supervisory position
Definition:
Administrative support staff for the claims department along with direct administrative
support to the Claims Manager
Basic Job Responsibilities:
a. Assist the Claims Manager and claims staff with various secretarial tasks, including
computer-generated reports and drafting basic letters.
b. Handle and route all calls, mail, emails, faxes and other correspondence for the claims
department.
c. Handle small first-party claims.
d. Setup and distribute claims to all claims staff.
e. Pay bills directly associated with claims, print checks and other reports as requested by
claims staff and accounting department.
f. File and maintain filing system.
g. Copy, print photos and other duties as needed by the claims staff.
h. Assist claims manager in administrative tasks as requested.
Skills:
1.
2.
3.
4.
5.
6.
7.
8.
Provide administrative support to manager and support the claims staff.
Have experience in administrative and clerical procedures and responsibilities.
Ability to handle multiple phone lines.
Ability to communicate effectively with customers, members and co-workers.
Must have current PC skills.
Excellent customer service skills.
Must be a cooperative team player.
Excellent time management skills and have the ability to prioritize tasks.
Page 6 of 32
D:\533572642.doc
9.
10.
11.
12.
Excellent organizational skills in atmosphere with frequent interruptions.
Ability to work well under pressure.
Willingness to attend trainings and other events as requested.
Willingness to perform other duties and responsibilities as needed.
Page 7 of 32
D:\533572642.doc
ICRMP
Claims Technician
Reports To:
ICRMP Claims Manager
Supervises:
Non-supervisory position
Definition:
Manage first- and third-party Auto, Property, General Liability and occasional Law
Enforcement and Errors & Omissions claims.
Job Responsibilities:
2. Claims Investigation:
a. Analyze and investigate claims and develop an action plan to facilitate dispositions.
b. Correctly determine policy coverage, complete a thorough investigation of the claim and
develop a clear understanding of all evidence relating to the claim.
3. Claim File Investigation:
a. Evaluate and determine the degree of member’s liability or damages, claimant’s damages,
and probable defense costs, and then set reserves based on most current information and
analysis.
b. Prepare and submit claim file reports in a timely manner.
c. Review claim files and diaries in a timely manner and keep file notes up-to-date.
d. Draft appropriate documents in a professional manner (declination letters, denial letters,
claim files reports, etc.).
4. Resolution of Claims:
a. Aggressively move a claim to either a denial or settlement by creative and proactive file
handling.
b. Maintain at minimum a 1:1 beginning to closing claim ratio.
c. Negotiate settlements within authority limit.
d. Arrange and attend settlement conferences, mediations, arbitration hearings and trials as
needed.
e. Coordinate and direct subrogation and recovery matters.
5. Management of Resources:
a. Prioritize and organize workload effectively and keep claim diaries current.
b. Must demonstrate strong communication and organizational skills.
c. Direct and control outside services, including attorneys and independent adjusters.
6. Computer Competence:
a. Must demonstrate competence in using computer systems and software to accomplish work
assignments.
7. Teamwork/Customer Service:
a. Work effectively with other ICRMP employees and members by being a team player.
b. Strong communication skills required along with the ability to keep your composure in
stressful situations.
c. Excellent writing and verbal communication skills required.
d. Must be able to effectively and pleasantly communicate with all ICRMP members.
Page 8 of 32
D:\533572642.doc
8. Travel/Training:
a. Ability to travel on occasion and be willing and able to attend various training sessions.
b. Willingness to become proficient in local governmental law.
c. Experience with public entity claims helpful but not required.
CLAIMS MANAGER DUTIES
REVIEW THE FOLLOWING:
Micro:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Expense reserve – expense paid
Reserve history dates
Timely CFRs
Litigation budget/plans
Timely contact w/insured & claimant
Coding: open-litigation; PL v. GL v. EO
Subrogation possibilities
Quality of file documentation
Coverage
Evaluation clear? Damage value x percentage of loss = reserve
Plan of Action? W/target dates?
Diaries
Macro:
3. Review $100,000+ claims
4. Review 5 years or older DOL claims
5. Spot check small property claims
Page 9 of 32
D:\533572642.doc
CLAIMS SPECIALIST DUTIES
Basic Job Responsibilities:
1. Analyze and investigate claims and develop an action plan to facilitate dispositions;
2. Prepare and submit claim file reports in a timely manner;
3. Place adequate reserves on files;
4. Maintain close contact with reinsurers, agents and members;
5. Direct and control outside services, including attorneys and independent adjusters;
6. Participate in resolving coverage issues;
7. Negotiate settlements within authority;
8. Arrange and attend settlement conferences, mediations, arbitration hearings and trials;
9. Provide proper guidance to members;
10. Coordinate and direct subrogation and recovery matters;
11. Maintain a good working relationship with members;
12. Review claim files and diaries in a timely manner and keep file notes up-to-date;
13. Attend training seminars as required;
14. Draft appropriate documents in a professional manner (declination letters, denial letters, claim files
reports, etc.);
15. Have knowledge of the Idaho Tort Claims Act and other laws pertaining to governmental liability;
and
16. Perform other duties as assigned.
Page 10 of 32
D:\533572642.doc
3. Steve Spilde, Chief Executive Officer, North Dakota Insurance Reserve Fund (NDIRF), provides the
following job descriptions, Claims Manager, Assistant Claims Manager, Outside Claims Adjuster,
Inside Claims Adjuster
Job Description
Claims Manager
EMPLOYEE NAME:
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Chief Executive Officer
PREPARED BY: Incumbent(s), CEO
DATE: October 1996
APPROVED BY:
DATE:____________
_______________________________________________________________________
1. INTRODUCTION: The incumbent directs, manages, supervises and coordinates the claims processing
function for the North Dakota Insurance Reserve Fund (NDIRF). Ensures that all claims are paid or settled
in accordance with the goals and objectives of the NDIRF. The incumbent provides the highest caliber of
professional advice, staff guidance, and support to the CEO and the NDIRF. This Job Description is not a
contract and is subject to change.
2. SUPERVISORY CONTROLS: Work is performed under the supervision of the Chief Executive Officer
(CEO). This is accomplished through delegation of authority, individual staff guidance, and expected
compliance with established policies. Highly unusual or complicated problems may be referred to the CEO
for further guidance or decision. Incumbent is expected to rely on his /her experience, judgment and
knowledge to resolve problems.
Performance is evaluated through direct observation, review of assigned work or projects, and compliance
with established policies and procedures.
*3. WORKING RELATIONSHIPS: Relationships with coworkers shall be guided by the following tenets:
The incumbent is cooperative and, when appropriate, assists others. Works to promote teamwork
within the department and throughout NDIRF. Shares information with peers. Resolves conflict
through the use of tact and diplomacy.
Accepts responsibility and works well when given responsibility. Accepts and is eager to learn new
duties. Offers suggestions to improve the activities of the department and the operation of NDIRF.
Continually strives to improve the proficiency of their job performance. Is a self-starter. Exhibits a
positive image and outlook when interacting with coworkers and/or the public. Serves as a positive
role model for others.
DUTIES AND RESPONSIBILITIES:
1. DEPARTMENT MANAGEMENT (30%)
ESSENTIAL FUNCTIONS;
Page 11 of 32
D:\533572642.doc
*a. Assumes management responsibility for all services and activities of the NDIRF Claims
department. Directs, participates and advises in the development and implementation of
goals, objectives, policies and priorities for assigned programs. Recommends and
administers, within policy guidelines, appropriate service and staffing levels, policies
and procedures.
b. Selects, trains, motivates and evaluates claims staff. Provides or coordinates staff
training and works with staff to correct deficiencies. Implements discipline and
termination procedures, if necessary.
*c. Exercises direct supervision of supervisory, professional, technical and support staff of
the Claims department Plans, directs, coordinates and reviews the work plan for the
NDIRF Claims department. Monitors and evaluates the efficiency and effectiveness of
service delivery methods and procedures at all times. Identifies and develops strategies
for the resolution of claims. Identifies opportunities for improvement in operations and
reviews with the CEO.
d. Works with the NDIRF departments in organizing joint activities and operations;
coordinates with and provides assistance to other departmental programs, as necessary
or appropriate. Provides responsible staff assistance to the CEO. Prepares and presents
staff reports; provides status reports regarding loss information, reserves, significant
claims and the progress and strategy involved for claims in litigation.
e. Participates in marketing and public relations efforts of the NDIRF, including
preparation of material for the newsletter, attendance at and participation in various
conferences, workshops and seminars as a representative of the NDIRF. Provides
technical support to members in the area of claims. Assists other NDIRF departments, as
appropriate, to facilitate the overall operation of the Fund.
2. CLAIMS MANAGEMENT (45%)
ESSENTIAL FUNCTIONS:
*a. Meets with all Claims department staff to identify and resolve problems; assigns and
prioritizes work activities, projects and programs; monitors work flow and
administrative and support systems, including internal reporting relationships. Ensures
the maintenance of adequate and appropriate reserves for all claims and reviews
reserves on a regular basis, adjusting as necessary. Responds to and resolves difficult
and sensitive inquiries or complaints; negotiates and resolves significant and
controversial issues.
b. Participates in the development and administration of the claims management program
budget, including the forecast of funds needed for staffing, equipment, materials and
supplies. Approves and monitors Claims' department expenditures and implements
adjustments as necessary.
OTHER DUTIES:
c. Attends and participates in professional group meetings and seminars, to maintain an
awareness and knowledge of current trends and innovations in the field of claims
management.
Page 12 of 32
D:\533572642.doc
d. Participates in adjusting claims, including conduct of investigations to determine liability
exposures and whether settlement is the most appropriate, cost-effective resolution of
claims; negotiates settlements and monitors the status of all assigned claims.
*3. CASE MANAGEMENT (25%)
ESSENTIAL FUNCTIONS:
*a. Monitors all claims involved in litigation; develops and maintains a list of independent
adjusters and attorneys who are qualified to represent the NDIRF; authorizes the use of
contract personnel as necessary and reviews and approves fees billed by contracted
claims personnel; meets regularly with attorneys engaged to defend NDIRF to plan for
litigation, attends depositions, settlement conferences, hearings and trials as appropriate
to facilitate the claims management function.
NOTE:
 Denotes Critical Performance Elements and/or Critical Tasks.
Page 13 of 32
D:\533572642.doc
POSITION QUALIFICATIONS STATEMENT
Claims Manager
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Chief Executive Officer
PREPARED BY: Incumbent(s), CEO
DATE: October 1996
APPROVED BY:
DATE:____________
_______________________________________________________________________
QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed below are representative of the
knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
1. A bachelor's degree or equivalent from an accredited college or university with major course
work in public administration, business administration or a related field; and
a. Seven years of increasingly responsible experience in handling multi-line claims,
including two years of supervisory experience in the field of insurance claims
management; or
b. A combination of education and experience that would provide the required
knowledge and abilities.
LANGUAGE SKILLS:
1. Ability to read and interpret laws and regulations, standards and documents, such as
policy/procedure manuals.
2. Ability to communicate clearly and concisely, both orally and in writing.
MATHEMATICAL SKILLS:
1. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers,
common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and
interpret bar graphs.
REASONING ABILITY:
1. Ability to analyze problems, identify alternative solutions, project consequences of proposed
actions and implement recommendations in support of goals.
2. Ability to calculate the financial impact of damages and liability for the NDIRF.
Page 14 of 32
D:\533572642.doc
CERTIFICATES, LICENSES, REGISTRATIONS:
1. Certified Property and Casualty Underwriter (CPCU) and/or Associate in Claims (AIC) is/are
desirable.
2. Possession of, or ability to obtain, a valid ND driver's license.
OTHER SKILLS and ABILITIES:
1. Ability to select, train, supervise and evaluate staff and effectively administer a variety of claims
management activities.
2. Ability to accurately estimate the potential for loss and the amount of reserves required and
negotiate settlements.
3. Ability to prepare and administer budgets.
4. Ability to develop and conduct presentations for seminars and conferences.
5. Ability to establish and maintain effective working relationships with those contacted in the
course of work.
6. Knowledge of, and ability to interpret and apply, federal, state and local laws, codes and
regulations; and of local government organization and policies and procedures.
7. Knowledge of operational characteristics, services and activities of a claims management
program, including negotiation and settlement principles, practices and documentation and
insurance, claims and legal issues as they relate to claims management.
8. Knowledge of basic tort liability law and the coverages offered by the NDIRF.
9. Knowledge of modern and complex principles and practices of program development and
administration and organization and management practices.
10. Knowledge of modern office procedures, methods and equipment including computers,
computer software, and related equipment.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to use hands to finger,
handle, or feel objects, tools, or controls; reach with hands and arms; talk and hear. The
employee frequently is required to sit. The employee is occasionally required to stand; walk; and
stoop, kneel, crouch, or crawl.
2. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities by
this job include close vision, distance vision, color vision, peripheral vision, and the ability to
adjust focus.
Page 15 of 32
D:\533572642.doc
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters
while performing the essential functions of this job. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential functions.
1. The work environment is typically an indoor business office environment however, while
performing the duties of this job, the employee occasionally works in outside weather
conditions.
2. The noise level in the work environment is usually moderate.
3. Occasional overnight travel is required.
Job Description
Assistant Claims Manager
EMPLOYEE NAME:
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Claims Manager
PREPARED BY: Incumbent(s), Manager, CEO
DATE: October 1996
APPROVED BY:
DATE:___________
_______________________________________________________________________
1. INTRODUCTION: The incumbent assigns, supervises, participates and reviews the work of North
Dakota Insurance Reserve Fund (NDIRF) Claims Department Staff. Additionally, the Assistant Claims
Manager is responsible for the adjustment and settlement of claims. The incumbent provides the highest
caliber of professional advice, staff guidance, and support to the Claims Department Manager and the
NDIRF. This Job Description is not a contract and is subject to change.
2. SUPERVISORY CONTROLS: Work is performed under the direct supervision of the Claims
Department Manager. This is accomplished through delegation of authority and expected compliance with
established claims handling procedures . Highly unusual or complicated problems may be referred to the
Claims Department Manager for further guidance or decision. Incumbent is expected to rely on his /her
experience, judgment and knowledge to resolve routine problems.
Performance is evaluated through direct observation, review of assigned work or projects, and compliance
with established policies and claims handling procedures.
*3. WORKING RELATIONSHIPS: Relationships with coworkers shall be guided by the following tenets:
The incumbent is cooperative and, when appropriate, assists others. Works to promote teamwork
within the department and throughout NDIRF. Shares information with peers. Resolves conflict
through the use of tact and diplomacy.
Accepts responsibility and works well when given responsibility. Accepts and is eager to learn new
duties. Offers suggestions to improve the activities of the department and the operation of NDIRF.
Continually strives to improve the proficiency of their job performance. Is a self-starter. Exhibits a
Page 16 of 32
D:\533572642.doc
positive image and outlook when interacting with coworkers and/or the public. Serves as a positive
role model for others.
DUTIES AND RESPONSIBILITIES:
*1. CLAIMS STAFF SUPERVISION (40%)
ESSENTIAL FUNCTIONS;
*a. Provides direct supervision of the professional and technical staff of the Claims
Department. Plans, prioritizes, assigns, supervises and reviews the work of NDIRF
claims staff, including review of all new loss notices for assignment to appropriate
claims personnel and monitoring of all claims reserves, recommending adjustments to
reserves as appropriate. Recommends and assists in the implementation of goals and
objectives, establishes schedules and methods for providing claims management
services and implements policies and procedures. Assists other NDIRF departments, as
appropriate, to facilitate the overall operation of the Fund.
*b. Meets regularly with claims staff to review progress in the administration and
settlement of all claims. Determines when settlement is the most appropriate and costeffective approach for resolution of a claim. Also, assists NDIRF Risk Services staff,
and provides appropriate and timely claims information.
c. Participates in the selection of claims staff. Provides or coordinates staff training,
evaluates performance, works with staff to correct deficiencies and implements
discipline procedures, if necessary.
Page 17 of 32
D:\533572642.doc
2. CLAIMS MANAGEMENT (60%)
ESSENTIAL FUNCTIONS:
*a. Supervises and participates in the NDIRF claims management function, acting in the
capacity of a claims adjuster, as necessary or appropriate. Conducts investigations and
analyzes contracts and evidence to determine liability exposures, the extent of coverage
and liability. Prepares a variety of specialized reports and correspondence regarding
operations of the claims department.
b. Oversees the work of independent attorneys and claims adjusters, regularly reviewing
progress and the status of each claim. Attends depositions, settlement conferences,
trials and alternative dispute resolution meetings pertaining to assigned claims.
OTHER DUTIES:
c. Implements and supervises plans to make salvage and subrogation recoveries.
d. Attends and participates in professional group meetings and seminars, to maintain an
awareness and knowledge of current trends and innovations in the field of claims
management.
NOTE: * Denotes Critical Performance Elements and/or Critical Tasks.
POSITION QUALIFICATIONS STATEMENT
Assistant Claims Manager
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Claims Manager
PREPARED BY: Incumbent(s), Manager, CEO
DATE: October 1996
APPROVED BY:
DATE: ____________
_______________________________________________________________________
QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed below are representative of the
knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
1. A bachelor's degree or equivalent from an accredited college or university with major course
work in public administration, business administration or a related field; and
a. Four years of increasingly responsible experience in handling multi-line claims,
including at least one year of lead or supervisory experience in the field of insurance
claims management; or
b. A combination of education and experience that would provide the required knowledge
and abilities.
Page 18 of 32
D:\533572642.doc
LANGUAGE SKILLS:
1. Ability to read and interpret laws, regulations, standards and documents, such as
policy/procedure manuals.
2. Ability to communicate clearly and concisely, both orally and in writing.
MATHEMATICAL SKILLS:
1. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers,
common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and
interpret bar graphs.
REASONING ABILITY:
1. Ability to plan, organize, direct and coordinate the work of assigned staff.
2. Ability to analyze problems, identify alternative solutions, project consequences of proposed
actions and implement recommendations in support of goals.
3. Ability to calculate the financial impact of liability and damages for the NDIRF.
CERTIFICATES, LICENSES, REGISTRATIONS:
1. Certified Property and Casualty Underwriter (CPCU) and/or Associate in Claims (AIC) is/are
desirable.
2. Possession of, or ability to obtain, a valid ND driver's license.
OTHER SKILLS and ABILITIES:
1. Ability to select, supervise, train and evaluate staff.
2. Ability to negotiate settlements.
3. Establish and maintain effective working relationships with those contacted in the course of
work.
4. Knowledge of operational characteristics, services and activities of a claims management
program, including good faith settlement and negotiation principles, practices and
documentation.
5. Knowledge of, and ability to interpret and apply, pertinent federal, state and local laws, codes
and regulations; and of local government organization, and policies and procedures.
6. Knowledge of basic tort liability law and the various coverage’s offered by NDIRF.
Page 19 of 32
D:\533572642.doc
7. Ability to accurately estimate the potential for loss and the amount of reserves required for
claims.
8. Knowledge of modern office procedures, methods and equipment including computers, computer
software, and related equipment.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to use hands to finger,
handle, or feel objects, tools, or controls; reach with hands and arms; talk and hear. The
employee frequently is required to sit. The employee is occasionally required to stand; walk; and
stoop, kneel, crouch, or crawl.
2. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities
required by this job include close vision, distance vision, color vision, peripheral vision, depth
perception, and the ability to adjust focus.
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters
while performing the essential functions of this job. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential functions.
1. The work environment is typically an indoor business office environment however, while
performing the duties of this job, the employee occasionally works in outside weather
conditions.
2. The noise level in the work environment is usually moderate.
3. Occasional overnight travel is required.
Page 20 of 32
D:\533572642.doc
Job Description
Outside Claims Adjuster
EMPLOYEE NAME:
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Assistant Claims Manager
PREPARED BY: Incumbent(s), Manager
DATE: October 1996
APPROVED BY:
DATE:___________
_______________________________________________________________________
1. INTRODUCTION: The incumbent performs professional and technical work in the on-site appraisal,
investigation and adjustment of claims for the North Dakota Insurance Reserve Fund (NDIRF); oversees the
activities of contracted independent adjusters and law firms. *The incumbent serves as ambassador at large
for the NDIRF, and conducts himself/herself in a professional manner at all times. This Job Description is
not a contract and is subject to change.
2. SUPERVISORY CONTROLS: Work is performed under the general supervision of the Assistant Claims
Manager. This is accomplished through delegation of authority and expected compliance with established
NDIRF policies and standardized claims handling procedures. Highly unusual or complicated problems
may be referred to the Assistant Claims Manager or Claims Department Manager for further guidance or
decision. Incumbent is expected to rely on his /her experience, judgment and knowledge to resolve routine
problems.
Performance is evaluated through: direct observation; review of assigned work or projects; completed claim
files; feedback received from agents, members, and claimants; and compliance with established NDIRF
policies, procedures and claims management practices.
*3. WORKING RELATIONSHIPS: Relationships with coworkers shall be guided by the following tenets:
The incumbent is cooperative and, when appropriate, assists others. Works to promote teamwork
within the department and throughout NDIRF. Shares information with peers. Resolves conflict
through the use of tact and diplomacy.
Accepts responsibility and works well when given responsibility. Accepts and is eager to learn new
duties. Offers suggestions to improve the activities of the department and the operation of NDIRF.
Continually strives to improve the proficiency of their job performance. Is a self-starter. Exhibits a
positive image and outlook when interacting with coworkers and/or the public. Serves as a positive
role model for others.
Page 21 of 32
D:\533572642.doc
DUTIES AND RESPONSIBILITIES:
1. CLAIMS ADJUSTING (75%)
ESSENTIAL FUNCTIONS:
a. Reviews loss notices, confirms coverage and monitors claims reserves as assigned.
Assists in determining assignment of claims to contracted independent adjusters.
*b. Conducts on-site investigations to inspect damage and determine liability exposures on
a state-wide basis. Collects oral and written statements, records, documents,
photographs from insured member(s) and claimant(s), and prepares diagrams which
support or dispute claims. Continuously updates skills to remain current with trends and
innovations in the claims management field.
c. Supervises contracted outside adjusters and reviews invoices submitted by independent
contractors to confirm material and labor costs and approves them for payment.
2. CLAIMS REPORTING (25%)
ESSENTIAL FUNCTIONS:
*a. Prepares memoranda and/or loss reports which support determinations regarding
liability and/or damage and negotiates prompt, equitable, cost-effective settlements.
b. Communicates regularly with agents and members regarding the status of claims.
c. Reviews the status of assigned claims with the Assistant Claims Manager on a regular
basis. Provides technical assistance to other NDIRF departments, as appropriate.
NOTE:
* Denotes Critical Performance Elements and/or Critical Tasks.
Page 22 of 32
D:\533572642.doc
POSITION QUALIFICATIONS STATEMENT
Outside Claims Adjuster
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Assistant Claims Manager
PREPARED BY: Incumbent(s), Manager,
DATE: October 1996
APPROVED BY:
DATE:____________
_______________________________________________________________________
QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed below are representative of the
knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
1. A bachelor's degree or equivalent from an accredited college or university with major course
work in public administration, business administration or a related field; and
a. Four to five years of increasingly responsible experience in handling multi-line claims;
or
b. A combination of education and experience that would provide the required knowledge
and abilities.
LANGUAGE SKILLS:
1. Ability to read and interpret laws, regulations, standards and documents, such as
policy/procedure manuals.
2. Ability to communicate clearly and concisely, both orally and in writing.
MATHEMATICAL SKILLS:
1. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers,
common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and
interpret bar graphs.
REASONING ABILITY:
1. Ability to accurately estimate the potential for loss, the amount of reserves required for claims
and the financial impact of liability and damages to the NDIRF.
2. Ability to interpret a variety of instructions furnished in oral, written, diagram or schedule form.
CERTIFICATES, LICENSES, REGISTRATIONS:
1. Associate in Claims (AIC) desirable.
Page 23 of 32
D:\533572642.doc
2. Possession of, or ability to obtain, a valid ND drivers license.
OTHER SKILLS and ABILITIES:
1. Ability to negotiate settlements, make decisions and work independently in the absence of
supervision.
2. Ability to establish and maintain effective working relationships with those contacted in the
course of work.
3. Knowledge of good faith settlement tactics and the operational characteristics, services and
activities of a claims management program, including negotiation and settlement principles and
practices.
4. Knowledge of insurance, claims and legal issues, including basic tort liability law, as they relate
to claims management.
5. Knowledge of general insurance principles, practices and terminology, including the various
coverages offered by the NDIRF.
6. Knowledge of state and local government organization, and policies and procedures.
7. Knowledge of modern office procedures, methods and equipment including computers, computer
software, and related equipment.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is frequently required to stand; walk; sit;
use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb
or balance; stoop, kneel, crouch, or crawl; talk and hear; and taste or smell.
2. The employee must frequently lift and/or move up to 50 pounds. Specific vision abilities
required by this job include close vision, distance vision, color vision, peripheral vision, depth
perception, and the ability to adjust focus.
Page 24 of 32
D:\533572642.doc
WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters
while performing the essential functions of this job. Reasonable accommodations may be made to enable
individuals with disabilities to perform the essential functions.
1. The work environment is typically an indoor business office environment however, while
performing the duties of this job, the employee frequently works in outside weather conditions,
wet/humid conditions; near moving, mechanical parts; in high, precarious places; fumes or
airborne particles; and risk of electrical shock.
2. The noise level in the work environment is usually moderate.
3. Overnight travel is frequently required.
Job Description
Inside Claims Adjuster
EMPLOYEE NAME:
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Assistant Claims Manager
PREPARED BY: Incumbent(s), Manager
DATE: October 1996
APPROVED BY:
DATE: ___________
_______________________________________________________________________
1. INTRODUCTION: The incumbent adjusts multi-line claims for the North Dakota Insurance Reserve
Fund (NDIRF), and provides both general and technical assistance to agents, members and the public
regarding claims inquiries. This Job Description is not a contract and is subject of change.
2. SUPERVISORY CONTROLS: Work is performed under the general supervision of the Assistant Claims
Manager. This is accomplished through delegation of authority and expected compliance with established
NDIRF policies and standardized claims handling procedures. Highly unusual or complicated problems
may be referred to the Assistant Claims Manager or Claims Manager for further guidance or decision.
Incumbent is expected to rely on his/her experience, judgment and knowledge to resolve routine problems.
Performance is evaluated through: direct observation; review of assigned work or projects; completed claim
files; feedback received from agents, members, and claimants; and compliance with established NDIRF
policies, procedures and claims management practices.
*3. WORKING RELATIONSHIPS: Relationships with coworkers shall be guided by the following tenets:
The incumbent is cooperative and, when appropriate, assists others. Works to promote teamwork
within the department and throughout NDIRF. Shares information with peers. Resolves conflict
through the use of tact and diplomacy.
Accepts responsibility and works well when given responsibility. Accepts and is eager to learn new
duties. Offers suggestions to improve the activities of the department and the operation of NDIRF.
Continually strives to improve the proficiency of their job performance. Is a self-starter.
Exhibits a positive image and outlook when interacting with coworkers and/or the public.
Serves as a positive role model for others.
Page 25 of 32
D:\533572642.doc
DUTIES AND RESPONSIBILITIES:
1. MULTI-LINE CLAIMS ADJUSTMENT (75%)
ESSENTIAL FUNCTIONS;
*a. Processes and resolves claims which can be handled in house by telephone or written
correspondence. This includes review of loss notices, confirmation of coverage,
investigation to determine liability exposures, participation in settlement negotiations and
monitoring reserves. Responsible for and has authority to adjust local claims within the
same authority as an outside adjuster.
b. Determines damages sustained by members and/or third-party claimants. For assigned
claims, contracts and supervises independent adjusters retained to help establish liability and
damages.
c. Communicates regularly with agents and other appropriate parties regarding the status of
claims and handles claims in a prompt, reasonable and cost-effective manner.
d. Reviews the status of assigned claims with the Assistant Claims Manager.
e. Analyzes contracts and evidence regarding assigned claims to determine if loss or defense of
claim can be shifted to other parties.
OTHER DUTIES:
f. Performs a variety of administrative duties in support of the NDIRF claims function,
including entry of data into established computer databases and preparation of
correspondence.
g. Performs salvage and subrogation recovery. Provides technical assistance to other NDIRF
departments, as appropriate.
*2. SCHOLASTIC CLAIMS ADJUSTMENT (25%)
ESSENTIAL FUNCTIONS;
*a. Processes scholastic injury claims, including establishment of reserves, determination of
processing dates and claimant eligibility, review
supplementation of files and prepare files
for issuance of checks, as
appropriate.
NOTE:
* Denotes Critical Performance Elements and/or Critical Tasks.
Page 26 of 32
D:\533572642.doc
POSITION QUALIFICATIONS STATEMENT
Inside Claims Adjuster
_______________________________________________________________________
EXEMPT: Yes
DEPARTMENT: Claims
LOCATION: Bismarck, ND
REPORTS TO: Assistant Claims Manager
PREPARED BY: Incumbent(s), Manager
DATE: October 1996
APPROVED BY:
DATE:____________
_______________________________________________________________________
QUALIFICATION REQUIREMENTS: To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements listed below are representative of the
knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
1. A two year college degree or equivalent, or specialized training in claims administration; and
a. Three to four years of experience in handling basic insurance claims; or
b. A combination of education and experience that would provide the required knowledge
and abilities.
LANGUAGE SKILLS:
1. Ability to read and interpret laws, regulations, standards and documents, such as
policy/procedure manuals.
2. Ability to communicate clearly and concisely, both orally and in writing.
MATHEMATICAL SKILLS:
1. Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers,
common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and
interpret bar graphs.
REASONING ABILITY:
1. Ability to calculate the financial impact of liability and damages for the NDIRF and accurately
estimate the potential for loss and amount of reserves required for claims.
2. Ability to interpret a variety of instructions furnished in oral, written, diagram or schedule form.
CERTIFICATES, LICENSES, REGISTRATIONS:
1. Associate in Claims (AIC) desirable.
2. Possession of, or ability to obtain, a valid ND driver's license.
OTHER SKILLS and ABILITIES:
Page 27 of 32
D:\533572642.doc
1. Ability to work independently in the absence of supervision.
2. Knowledge of good faith settlement tactics and the operational characteristics, services and
activities of a claims management program, including negotiation and settlement principles and
practices.
3. Knowledge of state and local government organization, and policies and procedures, as well as
basic insurance principles, practices and terminology.
4. Knowledge of basic tort liability law and of the various coverage’s offered by the NDIRF.
5. Ability to establish and maintain effective working relationships with those contacted in the
course of work.
6. Knowledge of modern office procedures, methods and equipment including computers and
related equipment.
PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to
successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is occasionally required to stand; walk; sit;
use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb
or balance; stoop, kneel, crouch, or crawl; talk and hear; and taste or smell.
2. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities
required by this job include close vision, distance vision, color vision, peripheral vision, depth
perception, and the ability to adjust focus.
WORK ENVIRONMENT: The work environment characteristics described here are representative of those
an employee encounters while performing the essential functions of this job. Reasonable accommodations
may be made to enable individuals with disabilities to perform the essential functions.
1. The work environment is typically an indoor business office environment.
2. The noise level in the work environment is usually moderate.
4. David Kormann, Executive Director, Missouri Public Entity risk Management Fund (MOPERM),
provides the following job descriptions, Risk Management Specialist I and II
MOPERM’s job descriptions are the following two pages.
Page 28 of 32
D:\533572642.doc
STATE OF MISSOURI
OFFICE OF ADMINISTRATION
EMPLOYEE SIGNATURE__________________________
DATE ___________
DIVISION OF GENERAL SERVICES
PERFORMANCE PLANNING AND
PROGRESS DISCUSSION
SUPERVISIOR SIGNATURE_________________________ DATE ___________
REVIEWER SIGNATURE____________________________ DATE ___________
TITLE/POSITION
RISK MANAGEMENT SPECIALIST 1
NAME
UNIT/SECTION
Moperm
DATE:
January 1, 2003
HOW DOES YOUR JOB CONTRIBUTE TO THE STRATEGIC PLAN OF THE DIVISION?
By providing cost effective liability coverages to Missouri public entities.
ESSENTIAL FUNCTION
(KEY RESULT AREA)
Claims Administration
OUTCOME OR PRODUCT
Efficient and economical claims
administration, which complies with
MOPERM’S quality and service
standards.
ACTIVITY OR TASKS
WHICH WILL PRODUCE THE
OUTCOME OR PRODUCT
Conduct prompt and thorough
investigation.
Evaluate information and make
decisions relative to coverage, liability
and damages.
Negotiate equitable settlements.
Administrative Support
Assistance to Management
Career Development
Continued development of knowledge
and skills essential to competent job
performance
Complete special projects as assigned.
Attend Risk Management/Claims
seminars and conferences as they
become available
Read professional/trade periodicals
Stay current on judicial, legislative,
industry and policy changes
Continue to improve computer skills.
Focus on customer needs
Staff and Public Relations
Customer satisfaction
Professional and productive work
environment
Enhanced image and reputation of
MOPERM
Page 29 of 32
D:\533572642.doc
Establish positive, constructive working
relationships with co-workers,
members, agents, and vendors.
Maintain effective communications and
project competency and
professionalism.
HELP NEEDED TO COMPLETE
THE ACTIVITY OR TASK
DISCUSSION DATES
STATE OF MISSOURI
OFFICE OF ADMINISTRATION
EMPLOYEE SIGNATURE__________________________
DATE ___________
DIVISION OF GENERAL SERVICES
PERFORMANCE PLANNING AND
PROGRESS DISCUSSION
TITLE/POSITION
Risk Management Specialist II
NAME
SUPERVISIOR SIGNATURE_________________________ DATE ___________
REVIEWER SIGNATURE____________________________ DATE ___________
UNIT/SECTION
MOPERM
DATE:
January 2, 2003
HOW DOES YOUR JOB CONTRIBUTE TO THE STRATEGIC PLAN OF THE DIVISION?
By providing cost effective liability coverages to Missouri public entities.
ESSENTIAL FUNCTION
(KEY RESULT AREA)
Claims and Litigation Management
OUTCOME OR PRODUCT
Cost effective and efficient claims
Adjustment
Control litigation costs and obtain positive
resolution of lawsuits
ACTIVITY OR TASKS
WHICH WILL PRODUCE THE
OUTCOME OR PRODUCT
Continuous monitoring and analysis of open
claims count, reserves and amounts paid,
customer satisfaction and work product of
department employees and outside personnel
Continuous monitoring of litigation files and
frequent communication with defense counsel
Provide semi-annual claim trend analysis to
Executive Director
Review claims procedures and duties of all
department employees to increase efficiency
and implement cross training of staff
Attend trials and other court proceedings
Analyze Member’s claims and provide
evaluation of loss history to Loss Control and
Member Services Staff
Risk Management
Reduce Losses
Complete special projects as assigned
Attend seminars and conferences that pertain
to topical issues
Administrative Support
Assistance to Executive Director
Career Development
Keep apprised of new developments in the
industry
Keep apprised of developments in case law
MOPERM membership will be better served
Public Relations
Page 30 of 32
D:\533572642.doc
Read trade journals and various newsletters
Maintain positive and professional working
relationship with staff, members, potential
members, agents, outside adjusters and
contracted attorneys
HELP NEEDED TO COMPLETE
THE ACTIVITY OR TASK
DISCUSSION DATES
CLAIMS DEPARTMENT PAY AND TENURE 2005-2005
PooI A
Claims Mgr / Attorney
Claims Technician
Claims Assistant
Claims Technician
Sr. Claims Technician
Claims Specialist
Sr. Claims Specialist
Sr. Claims Specialist
Pay
Type of Claims
2005 Number of Claims
$86,076.48
$15,061.06
$32,047.67
$40,314.20
$46,106.95
$47,934.66
$50,488.66
$53,207.06
Property
Liability
787
895
Pool B
Inside Adjuster
Outside Adjuster
Assistant Claims Manager
Claims Manager
Current Pay
$47,400.00
$60,350.00
$71,900.00
$96,600.00
Pay Range
$32,400.00
$41,200.00
$52,200.00
$71,400.00
Pay Range
$52,200.00
$63,200.00
$79,700.00
$104,400.00
Tenure
1@ 19 yrs
1@ 19 yrs
1@ 14 yrs
1@ 18 yrs
Current Pay
Pay Range
Pay Range
Tenure
$38,230.00
$51,800.00
$25,595.00
$31,000.00
$51,000.00
$22,000.00
$44,000.00
$62,000.00
$28,000.00
3@ 4 yrs
1@ 2 yrs
3@ 2.5 yrs
Pool C
Ppty Casualty Claims Reps
Claims Supervisor
Administrative Assistant
Page 31 of 32
D:\533572642.doc
2005
Number
Type of Claims of Claims
Property Casualty
1600
CLAIMS DEPARTMENT PAY AND TENURE 2005-2005
Pool D
Pay Range
Claim Examiner
Sr Claim Examiners
Claims Assistants
Claims Supervisor
$41,000 - $54,000
$55,000 - $66,000
$26,000 - $34,000
$65,000 - $80,000
Tenure
Claims Manager
Mbrshp Svcs Coordinator
Claims Supervisor
Senior Examiners
Claim Examiners
Claim Assistants
6 years
2 years
6 years
2 at 6 years 1 at 4 years
2 @ less than 1 yr, 1 @ 3 yrs
Type
of Claims
2005
Number of
Claims
Property
Liability
409
1028
Type
of Claims
2005
Number of
Claims
Property
Liability
98
1432
1@6yrs 1@4yrs 1@2yrs 1@1yr
Pool E
Average Pay
Pay Range
Tenure
$50,340.00
$39,288.00
$23,376.00
$37,812 - $55,848
$33,792 - $48,300
1 @ 18
2@ 5
1@ 2
Manager
Adjuster
Claims Clerk
Page 32 of 32
D:\533572642.doc
Download