167610
STATE RISK ADJUSTER 4
AS615 $42,952 - $84,302
Creation Date: 03/17/2003
Change Date: 01/01/2025
FUNCTION OF WORK:To investigate and analyze accidents or other incidents resulting in complex claims against the state, settling small claims and recommending appropriate settlement for larger and more complex claims.
LEVEL OF WORK:SUPERVISION RECEIVED:Broad review from a State Risk Adjuster 5.
SUPERVISION EXERCISED:May exercise functional supervision over lower level State Risk Adjusters.
JOB DISTINCTIONS:Differs from the State Risk Adjuster 3 by performing the most complex and problematic claims investigations and by a higher claim payment authority limit.
Differs from the State Risk Adjuster 5 by the absence of supervisory responsibility.
CORE COMPETENCIES:
IDENTIFIED BY STATE CIVIL SERVICE, CORE COMPETENCIES ARE THE KNOWLEDGE, SKILLS,
ABILITIES AND BEHAVIORS BASED ON THE WORK TASKS OUTLINED IN THE EXAMPLES OF WORK.
MORE INFORMATION ON THE SCS COMPETENCY MODEL CAN BE FOUND
HERE.
| Building and Supporting Teams | Communicating Effectively | Demonstrating Accountability |
| Driving Results | Making Accurate Judgments | Thinking Critically |
EXAMPLES OF WORK:EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.
Conducts complex property and casualty claims investigations, acquiring evidence to validate and adjust such claims.
Investigates and pursues second injury fund claims.
Takes recorded statements or causes depositions to be taken from all parties involved in a claim; conducts surveillance to collect evidence of fraud in claims cases, request medical records and may summarize the records, obtain police reports, and request independent medical exams.
Gathers physical evidence from the scene of the incident and determines the probable amount of exposure of loss; appraises physical damages in property and casualty claims.
Coordinates activities of attorneys, investigators, physicians and other specialized personnel in the resolution of claims cases.
Serves as lead adjuster in handling the most complex claims and may coordinate subordinate adjusters in all types of claims to provide the most efficient and economic defense and settlement of claims against the State, State agencies and employees.
Assumes an active role in litigation management evaluating cases, working closely with the defense attorney developing strategy, budget and defense of case.
Consults with claimants and/or their attorneys concerning the possibilities of settlement of claims and negotiates the most complex personal injury, casualty and property claims.
Attends and/or testifies in trials on a regular basis, in both State and Federal courts.
Pursues third parties and/or insurers, where applicable, to ensure receipt of claims payments owed by such parties and protect the state's subrogation interest.
Handles the disposition of salvage if applicable.
Assists in the training of claims adjusters.
QUALIFICATION REQUIREMENTS:MINIMUM QUALIFICATIONS:
Five years of experience in insurance claims adjusting, examining, or investigation; accident investigation, legal research, project management, contract management, or construction management; OR
Six years of full-time work experience in any field plus two years of experience in insurance claims adjusting, examining, or investigation; accident investigation, legal research, project management, contract management, or construction management; OR
A bachelor's degree plus two years of experience in insurance claims adjusting, examining, or investigation; accident investigation, legal research, project management, contract management, or construction management; OR
An advanced degree in risk management or insurance, business or public administration, safety or legal studies, construction management, or a health services field plus one year of experience in insurance claims adjusting, examining, or investigation; accident investigation, legal research, project management, contract management, or construction management.
EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.