NATURE OF WORK
This is specialized technical work in the investigation, analysis, processing and adjustment of public liability or Workers’ Compensation claims in the Liability or Workers’ Compensation Sections of the Risk Management Division.
Work involves the investigation and evaluation of claims for alleged damages and personal injury arising from the operation or use of county property and from county employment. Responsibilities include development and maintenance of case files and testifying to their content and validity in hearings. Employees may determine subrogation potential of cases and assist in obtaining claim settlements. Independent judgment is exercised within established policies and procedures. Supervision is provided through review of file audits, authorization requirements, reports and observation of work activity and efficiency of operation.
Interviews to obtain claim reports for Workers' Compensation, bodily injury and property damage; assists in obtaining third party claim statements; evaluates and processes claims, following cases from initial report through the final disposition of the case.
Establishes and maintains assigned claims, accidents and occurrence case files; testifies in hearings to the content and validity of the case record.
Authorizes medical treatment in Workers' Compensation cases; reviews and ascertains accuracy of medical treatment charges submitted for payment; assures that such charges are in accord with the Workers' Compensation fee schedule.
Processes Workers' Compensation benefit and liability payments; monitors financial reserves for claims payment.
Prepares and maintains Workers' Compensation and public liability fiscal statistics; compiles data on lost work time and compensatory payments to county employees.
Negotiates with claimants and attorneys within established limitations and under the direction of the supervisor.
Attempts to affect equitable settlement without litigation.
Performs related work as required.
KNOWLEDGE, ABILITIES AND SKILLS
Knowledge of the general theory and content of public liability negligence and Workers' Compensation laws.
Knowledge of public liability statutes, Workers' Compensation statutes, and procedures applicable to self-insurance.
Knowledge of liability claims administration.
Knowledge of the techniques of investigation, adjustment, and settlement.
Knowledge of medical terminology as related to reviewing diagnostic and treatment records.
Ability to process complex claims, reporting and payment systems.
Ability to prepare and maintain fiscal records with accuracy and thoroughness.
Ability to express ideas clearly and concisely, both orally and in writing.
Ability to serve the public and fellow employees with honesty and integrity in full accord with the letter and spirit of Broward County's Ethics and Conflict of Interest policies.
Ability to establish and maintain effective working relationships with the general public, co-workers, elected and appointed officials and members of diverse cultural and linguistic backgrounds regardless of race, religion, age, sex, disability, or political affiliation.
REQUIRED EXPERIENCE AND TRAINING
Graduation from high school supplemented by specialized training in insurance claims, practices and procedures; experience in claims processing including some experience adjusting bodily injury, property damage or Workers’ Compensation claims; or any equivalent combination of training and experience.
Possession of a Florida All-Lines Adjustor’s License (5-20 or 6-20) or a Workers’ Compensation License (5-24 or 6-24) from the State of Florida Division of Insurance Agent and Agency Services must be obtained within 18 months of employment.
Bargaining Unit: White Collar
FLSA Status: Non-exempt
Code of Ethics Certification: No
Class Spec Estab./Revised: E2/81 R7/15