Risk/Claims Specialist

General summary

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.

Knowledge, skills & abilities

In addition to those identified in the previous levels: Knowledge of underwriting and/or and claims adjudication processes. Ability to secure and evaluate information, make decisions, and prepare reports. 

Typical qualifications

Bachelor’s degree and 0-2 years of experience. (Substitutions may be allowed.)

Pay grade