Under direction, performs a variety of professional claims review, evaluation, investigation, adjusting, and processing duties in support of the ABAG PLAN Corporation. Areas of responsibility include, but are not limited to, general liability and first party property claims; collaborates with assigned municipalities on claims, training and related matters; ensures compliance with mandated and ABAG PLAN policies, procedures, rules and regulations; prepares and maintains a variety of claims related documents and files; performs bid comparisons, writes estimates for residential and business properties, solves routine claim problems, organizes work to meet department standards for accuracy and timeliness, manages records system and claim diary systems; and performs related duties as required.
DUTIES INCLUDE: (The examples may not cover all duties which may be performed)
• Receives and reviews incoming claims for sufficiency and timeliness; assesses claim relative to client coverage and validity; ensures claim is properly documented in the claims system
• Contacts relevant parties with respect to the claim including client, claimant and witnesses; obtains and documents any pertinent information related to the claim
• Conducts investigation into claims allegations by analyzing documentation, visiting sites, taking photographs, and interviewing the claimant(s) and witnesses
• Establishes property damage extent and recovery possibilities; determines exposure and advises client accordingly
• Sets reserves appropriate for claim and monitors reserves on a continuous basis
• Evaluates results of investigation and claims documentation; negotiates and recommends claim settlement consistent with professional practices and ABAG/client directives
• Processes and pays claims within designated authority level; prepares payment request forms
• Provides customer support to clients; conducts on-site meetings to present claims related training, provide status updates on pending claims and dialog on other relevant issues; markets ABAG PLAN services to assigned members
• Prepares a variety of technical reports and letters with respect to claims activities including evaluations, letters to claimants and attorneys, business interruption evaluations and supporting documentation
• Performs a variety of administrative tasks including filing, copying and entering data into the computer system
• Prepares and maintains a variety of claims related records and files including activity logs
• Prepares for, and attends mediation, rehabilitation and related hearings to represent ABAG and client interests
• Handles re-insurance claims for clients by reporting excess insurance claims and corresponding with carriers; reports and requests reimbursement on the client’s behalf
• Receives and reviews incident reports for content and liability assessment
• Administers and coordinates emergency housing services, restoration and repair services, car rental services and medical benefits or payment of damages by determining appropriate housing services, choosing contractors and approving bills for payment
• Requests and obtains documentation from third parties such as medical records, or statements from physicians and employers
• Performs related duties as required
ADDITIONAL INFORMATION
In 2015, work location will move to Folsom Street and Beale Street in San Francisco.
COMPENSATION AND BENEFITS
Salary: $5,690 - $6,917 per month
Pension: Employee pays CalPERS 6.25% of salary toward 2.0% @ age 62 or 2.5% @ 67 retirement plan
Social Security: Employee pays 6.2% of salary
Deferred Compensation: STARS/UTC 457 and/or ICMA-RC Retirement Plan (Voluntary)
Retiree Medical Account: $100 per month
Health and Dental Plans: Several HMO and PPO Medical Plans, Dental Insurance, and VSP Vision. Out-of-pocket contribution may be required depending on selected coverage.
Life Insurance: ABAG Paid coverage equal to 2 times annual salary
Other Benefits: Public Transit Vouchers and pre-tax options for eligible health care and dependent care expenses
Vacation, Sick Leave, Holidays: Competitive leave package including 11 paid holidays and 3 floating holidays annually
APPLICATION PROCESS
Please submit a cover letter, resume, and employment application to:
ABAG H.R. 13-77
P.O. Box 2050
Oakland, CA 94604-2050
AN AGENCY APPLICATION IS REQUIRED AND MAY BE OBTAINED AT
www.abag.ca.gov/jobs.html OR BY SENDING A SELF-ADDRESSED, STAMPED ENVELOPE TO ABAG–H.R. 13-77, P.O. BOX 2050, OAKLAND, CA 94604-2050. FOR INFORMATION CALL
510/464-8496. POSITION IS OPEN UNTIL FILLED AND MAY BE CLOSED AT ANY TIME. ABAG IS AN EQUAL OPPORTUNITY EMPLOYER. QUALIFIED DISABLED INDIVIDUALS ARE PROTECTED AGAINST DISCRIMINATION.
QUALIFICATIONS (KNOWLEDGE, SKILLS, AND ABILITIES):
• Operations, services and activities of a comprehensive liability claims program
• Methods and techniques of investigating and evaluating a wide variety of claims
• Operational characteristics of field and office equipment used in evaluating and documenting claims
• Mandated rules, regulations, policies, procedures and standards governing claims examination, investigation and processing
• Laws and methods of determining compensability
• Methods and techniques of determining and setting reserve amounts
• Methods and techniques of evaluating potential liability on a wide variety of claims
• Principles and practices of risk management
• Methods and techniques of conducting research and statistical analysis
• Methods and techniques of investigating and determining the existence of fraudulent claims
• Principles and practices of business correspondence and report development
• Computer applications related to the work, including word processing, spreadsheet and specialized claims applications
• Federal, State, and local laws, ordinances and regulations related to assigned area of responsibility, including the California Government, Vehicle and Penal Codes
• MS Office Suite (Word and Excel)
• A valid CA Driver’s license and clean driving record. Possession of, or the ability to obtain, a California Class C driver’s license by the time of appointment is required.
EDUCATION AND EXPERIENCE
Bachelor’s degree or equivalent from an accredited college or university with major course work in business administration, public administration or a related field and a minimum of three (3) years of progressively responsible claims adjustment experience including construction estimate writing using property damage cost estimate software is required. Experience with the public sector and adjusting sewer/water claims is also required. Experience in adjusting total losses and water damage claims, including remediation techniques, and an understanding of legal liability and subrogation issues is desired.