Claims Analysis (Claims Specialist III)

Job Announcement

Under general supervision, administers the county’s property and general liability, workers’ compensation, and professional liability self-insurance/insurance claims programs. Provides team lead oversight and serves as technical resource to the claims staff. Investigates and resolves all levels of claim types of high complexity at an advanced level. Conducts program analysis and assists with long-range planning for the claims operations to ensure compliance with Risk Management’s program goals and objectives. Develops and implements appropriate claims policies and procedures and prepares necessary management reports. Interacts with the County Attorney’s office, staff in other county agencies, and citizens to resolve complex claims issues. Performs other administrative tasks associated with the claims program.

Note: Salary offer will not exceed the mid-point of the salary range $103,520.14.

Illustrative Duties

• Monitors internal/external customer service claim questions/concerns;
• Provides necessary oversight of the Third Party Administrator for worker's compensation claim handling of the assigned agencies;
• Reviews all incoming claims and makes assignments to technical staff;
• Completes both telephonic and field investigations;
• Obtains appraisals and other needed information from claimants, witnesses and other interested parties;
• Interviews insured, claimants, witnesses and other interested parties;
• Analyzes information obtained in order to evaluate claims;
• Determines coverage and extent of loss or liability;
• Ensures payments are issued and releases obtained;
• Maintains and monitors claim systems;
• Provides necessary oversight to assure satisfactory performance by all vendors;
• Interacts with the County Attorney's Office and agency personnel in resolving complex claim issues.

Required Knowledge Skills and Abilities

• Considerable knowledge of mission, goals, and objectives of the risk management division;
• Considerable knowledge of the principles, practices, and techniques relating to loss prevention and safety;
• Ability to identify possible solutions for solving business problems;
• Ability to write detailed, accurate reports;
• Ability to make oral presentations to department management, other departments, or the public.

Employment Standards

MINIMUM QUALIFICATIONS: 
Any combination of education, experience, and training equivalent to the following:
(Click on the aforementioned link to learn how Fairfax County interprets equivalencies for “Any combination, experience, and training equivalent to”)
Graduation from an accredited four-year college or university with a bachelor's degree in field related to risk or claims management, insurance, finance, business administration, or other related field; plus four years of complex claims professional work experience.

CERTIFICATES AND LICENSES REQUIRED: 
Valid driver's license.

NECESSARY SPECIAL REQUIREMENTS: 
The appointee to this position will be required to complete a criminal background check, credit check, and a driving record check to the satisfaction of the employer. Credit check is required every four years, thereafter.

This position is emergency/essential services personnel. (Required to report for duty during inclement weather and/or other emergencies.)

PREFERRED QUALIFICATIONS:
 

• Associate in claims designation and/or other risk management designation.
• Experience with and detailed knowledge of the Virginia Workers’ Compensation and tort liability laws.
• Demonstrated familiarity with legal and medical terminology.
• Experience with personal computers and computerized claims systems.
• Experience in the handling of, or work in, a municipal self-insured claims environment.
• Ability to work independently.
• Excellent written and oral communication skills.

PHYSICAL REQUIREMENTS:
Job is generally sedentary in nature. Ability to read data on computer monitor; operate keyboard driven equipment; motorized vehicle; and carry items up to 15 lbs.  All duties performed with or without reasonable accommodations.

SELECTION PROCEDURE:
Panel Interview and may include a practical exercise.

 

The population of Fairfax County is very diverse where 38.7% of residents speak a language other than English at home (Spanish, Asian/Pacific Islander, Indo-European, and others) and we encourage candidates bilingual in English and a foreign language to apply to this opportunity.

Fairfax County Government prohibits discrimination on the basis of race, color, religion, national origin, sex, pregnancy, childbirth or related medical conditions, age, marital status, disability, sexual orientation, gender identity, genetics, political affiliation, or military status in the recruitment, selection, and hiring of its workforce.  

Reasonable accommodations are available to persons with disabilities during application and/or interview processes per the Americans with Disabilities Act. Contact 703-324-4900 for assistance. TTY 703-222-7314. DHREmployment@fairfaxcounty.gov. EEO/AA/TTY.