Risk Management Claims Specialist

Full Time
Fairfax, VA 22031
Posted
Job description
Description

Under direction of the Manager, Security & Safety, the Risk Management Claims Specialist provides advisory support to senior management in key areas of property, casualty and Workers Compensation insurance claims management. The Risk Management Claims Specialist will cultivate and maintain positive working relationships with employees and claimants by ensuring prompt and efficient delivery of risk management, claim, and customer service. The individual will be responsible for providing risk management and claims services such as receiving and adjusting property/casualty and workers compensation claims by performing investigations/site inspections, evaluating liability, verifying coverages, and negotiating fair and equitable resolutions that minimize the cost and negative implications to the Organization.

The Risk Management Claims Specialist will also assist the Manager, Security & Safety conducting reviews of overall risk management strategies, as well as evaluating and implementing commercial insurance products to minimize costs while managing the risk of major claims to the Organization. They will assist in the analyses of risk coverage and insurance strategies including self-insurance, commercial insurance and/or a combination of deductibles and umbrella coverage for areas such as general liability, automobile, property, Workers Compensation and Directors’ and Officers’ coverage and assist in the design and administration of special insurance programs for areas such as pollution and cyber insurance.

Examples of Duties

  • Investigate incidents and/or complaints determining whether claims need to be filed with appropriate insurance carriers.
  • Communicate with a variety of claimants, employees, legal representatives and insurance brokers/representatives to coordinate the review and processing of claims.
  • Coordinate claims processing to minimize legal and monetary impacts to the Organization.
  • Monitor pending claims including general liability, automobile, property, Workers Compensation, and Directors’ and Officers’.
  • Assist in conducting detailed investigations of large risk claims at various Fairfax Water locations.
  • Initiate claims, with management approval, against other parties responsible for damages to Fairfax Water property.
  • Assist Fairfax Water legal representatives in preparing for legal actions filed against or on behalf of the Organization.
  • Assist in evaluation of appropriate insurance methodology (self-insurance, commercial insurance, deductibles, etc.) for specific risks.
  • Assist in the evaluation of commercial insurance and, as appropriate, renew existing policies or assist in the development of specifications for bids.
  • Assist in the design and administration of special insurance programs for risks such as professional liability, Directors’ and Officers’ liability, cyber liability and environmental liability.
  • Investigate complex or potentially high-cost incidents and/or complaints determining whether claims need to be filed with appropriate insurance carriers.
  • Communicate with a variety of claimants, employees, legal representatives and insurance brokers/representatives to coordinate the review and processing of claims.
  • Monitor and coordinate pending complex claims including general liability, automobile, property, Workers Compensation, and Directors’ and Officers’ claims to reduce risk and potential legal impacts.
  • Conduct detailed investigations of large risk claims at various Fairfax Water locations.
  • Initiate claims, with management approval, against other parties responsible for damages to Fairfax Water property.
  • Assist Fairfax Water legal representatives in preparing for complex/high monetary risk legal actions filed against or on behalf of the Organization.
  • Assist the Organization by working as a liaison between our appointed insurance counsel and staff to gather information requested through the discovery process of legal proceedings that come about as the result of an insurance claim. These duties may include preparing responses to interrogatories, participating in depositions, attending legal proceedings, and participating in mediated settlement negotiations.
  • Performs other duties as assigned or required

Typical Qualifications

  • Bachelor’s degree in a related field and a minimum of 2 years related responsible risk management, property - casualty insurance and claims management experience, or 6 years related experience.
  • Knowledge of workers' compensation, property and liability claims legislation, regulations, policies, processes, and procedures.
  • Knowledge and understanding of the principle and procedures for the investigation and processing of casualty/liability/workers compensation insurance claims.
  • Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
  • Ability to work effectively and maintain a strong working relationship with managers, supervisors, employees, the public, and other organizations.
  • Ability to use independent judgement and make appropriate insurance claims adjustment decisions and determinations.
  • Conflict resolution and/or mediation skills.
  • Knowledge of process requirements of administrative hearings and litigation.
  • Ability to respond after-hours to emergency events.
  • Ability to make timely judgments and recommendations.
  • Possession of a valid Driver's license and good driving record.
  • Must pass a controlled substance (drug) test.

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