STATE RISK ADJUSTER 5

AS617 $49,192 - $96,533
Creation Date: 03/17/2003
Change Date: 01/01/2025

FUNCTION OF WORK:
To supervise a unit of claims adjusters for the State's multi-line property and casualty self-insurance program.

LEVEL OF WORK:
Supervisor

SUPERVISION RECEIVED:
Broad review from the State Risk Adjuster 6.

SUPERVISION EXERCISED:
Line over lower level State Risk Adjusters.

JOB DISTINCTIONS:
Differs from the State Risk Adjuster 4 by serving in a supervisory capacity and by a higher claim payment authority limit.

Differs from the State Risk Adjuster 6 by the absence of responsibility for the full claims adjusting division.

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.

Accepting Direction	Building and Supporting Teams	Demonstrating Accountability
Displaying Expertise	Driving Results	Making Accurate Judgments
Managing the Employee Lifecycle

EXAMPLES OF WORK:
EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.

Supervises the activities of adjusters who conduct comprehensive investigations and prepare the defense or negotiate settlement of insurance claims.

Interviews, selects, and trains adjusters in adjusting policies and procedures; assigns work, determines priorities; assesses work of subordinates by reviewing case files for correctness and completeness of data and to ensure adherence to established guidelines, policies and procedures.

Evaluates cases involving litigation and assigns cases to adjusters based on level of complexity; refers the most complex and sensitive cases to the Attorney General for legal opinions, especially cases requiring legal interpretation and/or posing major financial losses to the state; submits all completed case analyses to the Attorney General.

Serves as a voting member of the Claims Council that authorizes claims settlements up to a limit of $500,000; monitors payments due to claimants from commercial carriers to ensure payments of claims by private insurers.

Engages in joint projects with the loss prevention unit and the underwriting section, coordinating the activities of subordinate adjusters to address and resolve special problems in specific agencies and departments which have produced, or could result in, personal injury and/or property damage.

Participates in contract negotiation for professional claims adjusting and legal services.

May perform the duties of the State Risk Adjuster 6 in his/her absence.

Supervises and administers the application of the worker's compensation laws, rules, regulations, policies and procedures; reviews and analyzes applicable legislation and recommends changes as necessary.

Receives and processes all petitions filed by employees to receive compensation for work related injuries; approves cooperative agreements for rehabilitation services, monitoring the quality and quantity of work.

Testifies in court with respect to workers' compensation cases.

Oversees the rehabilitation of injured workers, working closely with the rehabilitation efforts of the physician and rehabilitation counselors in an effort to return the claimant to a gainful occupation within the shortest possible time.

Evaluates permanent partial and permanent total disability cases upon completion of the rehabilitation program to determine claimant's occupational ability.

QUALIFICATION REQUIREMENTS:
MINIMUM QUALIFICATIONS:
Six 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 three 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 three 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 two years 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.