Claims Specialist II

Job Announcement

Reports directly to the claims manager. Assist in the revisions of operational procedures and best practices. Provides oversight of the claims service provider in the management of workers' compensation claims to ensure compliance with contract requirements. Responsible for providing management reports to the risk management staff on the claims operations and claims service provider. Works closely with all county agencies, including the county attorney's office, in development of defense strategies. Works as a member of the risk management team on strategic planning and goal objectives, provides training to all county agencies on risk and claims management related matters. Investigates and handles to conclusion, all auto, general liability, first party and property claims.

 

Illustrative Duties

(The illustrative duties listed in this specification are representative of the class but are not an all inclusive list. A complete list of position duties and unique physical requirements can be found in the position description.)

• Reviews all claim recommendations;
• Performs analysis and adjusting of special claims and complaints;
• Monitors and reports on production and quality assurance (audits);
• Monitors internal/external customer service claim questions/concerns;
• Provides oversight and direction for the care of seriously injured employees;
• Administers procedures for reserving, recording and analyzing claims;
• Provides technical direction to Claims Specialists;
• Oversees the claims workflow;
• Provides oversight of the rehabilitation process and maintains effective working relationship with agencies to expedite the return of disabled employees covered by workers' compensation to maximum function.

Required Knowledge Skills and Abilities

(The knowledge, skills and abilities listed in this specification are representative of the class but are not an all inclusive list.)

• Knowledge of the mission, goals, and objectives of claims management;
• Knowledge of the principles, practices and techniques relating to claims management;
• Ability to perform a variety of increasingly complex work in areas relating to claims management;
• Ability to identify possible solutions for solving business problems;
• Ability to communicate effectively orally and in writing;
• Ability to use word processing, spreadsheet, and presentation software to prepare documents and to store, manipulate, analyze and present information;
• Ability to train and supervise staff.

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 the field related to insurance, claims management, finance, business administration, or other related field; plus two years of complex claims professional work experience.  

CERTIFICATES AND LICENSES REQUIRED: 

None

NECESSARY SPECIAL REQUIREMENTS: 

The appointee to this position will be required to complete a criminal background and credit check to the satisfaction of the employer. 

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

PREFERRED QUALIFICATIONS: 

• Designation and/or an Associate in Claims (AIC) Designation.
• Experience with and knowledge of Virginia Workers' Compensation and tort liability laws.
• Experience with claims investigation techniques.
• Strong analytical and problem-solving skills.
• Excellent oral and written communication skills.
• Strong customer service experience.
• Experience multi-tasking, managing priorities, and adapting to a fluid work environment.
• Multi-line claim handling experience.

PHYSICAL REQUIREMENTS:
Job is generally sedentary in nature. Ability to read data on computer monitor; operate keyboard drive equipment; operate a 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.