Risk/Claims Management

This is a position responsible for entry-level work within set guidelines and under direct supervision. A position at this level will assist employees and state and public entities with reporting of claims and/or exposures; process payments for property, liability, and/or workers' compensation claims; assist with the review of rating factors to determine appropriate rate classifications; and assist with review of applications and questionnaires to determine potential risk exposures. 

This is mid-level work investigating and negotiating claims and approving payments within established levels of authority for Risk Management's workers' compensation, property, and/or liability programs. Positions at this level correspond and communicate with injured workers, state and public entities, medical and legal professionals, insurance providers, and/or others, and provide one-on-one assistance with the reporting and processing of claims.

This is a supervisory position accountable for efficient operations and ensuring staff assignments are completed accurately and within set guidelines. At this level, employees also assist with the review of rating factors to determine appropriate rate classifications, and review information to determine potential risk exposures. Supervision at this level involves performing and reviewing the work overseen.

This is a professional position responsible from inception to conclusion for routine claims or underwriting and evaluation of potential loss exposures which represent the legal interests and obligations of the State. At this level incumbents may review rating factors to determine appropriate rate classifications, collect and formulate technical underwriting data, or review adequacy of claim documentation. This involves applying facts obtained through investigation and/or research to identify whether a claim is to be accepted or denied.  Employees at this level have the autonomy to evaluate the economic value and complete necessary documentation to award benefits (typically not more than $25k); complete administrative orders setting forth the claim decision based on established laws, policy, and procedure; and may provide testimony or support to the legal process. Research processes and documentation are typically routine or standard in nature and supervision ranges from direct to general depending on the nature of claim decision.

This is an advanced professional position responsible from inception to conclusion for unique, complex, or high monetary claims or evaluation of potential loss exposures and underwriting of claims. Employees independently develop effective strategies to satisfactorily resolve claims. When accepting a claim, employees at this level have the autonomy to evaluate the economic value and complete necessary documentation to award benefits up to a predetermined payment authority limit. Employees also complete administrative orders setting forth the claim decision based on the most appropriate laws, policy, and procedures. A position at this level may represent an area of knowledge (e.g. loss control) and provide functional expertise; provide advice on the most appropriate course of action; or provide testimony or other support to the legal process.

This is a supervisory position responsible for the oversight of risk/claims professionals. At this level positions are accountable for efficient operations and activities of risk management professionals including determining and setting performance standards. Employee supervision includes making hire recommendations, training, planning and assigning work, performance assessment, coaching, and progressive discipline. In addition, incumbents will be expected to have the knowledge and skills to perform and review the work overseen.

This is a manager position responsible for the management of risk/claims professionals. At this level, employees are responsible for claims within their designated area and have the authority to grant final approval on payments up to a designated amount. Employees may represent an area of knowledge (e.g. loss control) and provide functional expertise related to policy, procedures, etc. Employee supervision includes hire recommendations, training, planning and assigning work, performance assessment, coaching, and progressive discipline. In addition, this incumbents will be expected to have the knowledge and skills to perform and review the work overseen.