New job Risk Management Claims Adjudicator in Idaho

1. Claims investigation/adjudication.

• Investigates and determines legal liability of claims by analyzing and applying tort, federal and civil law, immunities, theories of negligence and comparative negligence, adjusting principals, insurance coverage and exclusions, and determining responsible parties and related coverages
• Verifies that claims are properly filed in accordance with related laws
• Implements file set-up, coding and computer input
• Insures coverage verification
• Determines and retains information necessary before claims can be evaluated
• Analyzes loss reports and claims to determine severity of loss and liability of the State
• Conducts interviews with parties
• Assigns and directs investigations by outside adjusters
• Analyzes and evaluates evidence gathered for completeness
• Evaluates bodily injury claims, and works with medical personnel to interpret and analyze severity and appropriateness of injury's claimed
• Serves as liaison between state agencies, insurance adjusters, claimants and/or attorneys regarding claims processing
• Seeks subrogation to collect reimbursement

• Determines direction and procedures for claims management
• Works with legal counsel to develop defense strategies
• Evaluates and approves aspects of discovery to be conducted by counsel
• Communicates by telephone and in writing with claimants, state agencies, witnesses, adjusters, and attorneys
• Determines legal and liability reserves, and monitors them for needed adjustments
• Monitors course of trial proceedings and coordinates with counsel regarding proceedings
• Acts as liaison between agencies and counsel
• Conducts and directs settlement negotiations
• Substantiates that correct settlement sums have been indicated and documents are prepared and filed accordingly
• Directs file set-up, computer entry, and that correspondence and reports are appropriate
• Provides claim coverage and procedural information to the public and state agency customers as necessary

• Identifies hazards and loss trends through the adjustment of claims and incidents
• Participates in development of information to promote public relations by educating and instructing state agencies on loss trends and identifiable hazards

Experience:

• investigating, evaluating, adjusting, and settling first and third party claims;
• directing the activities of defense counsel and independent adjusters pertaining to civil tort law cases;
• applying the Idaho Tort Claims Act (ITCA) in the adjudication of public entity claims;
• applying claims management/loss control practices;
• operating a personal computer for word processing and entering and retrieving data.

The successful candidate will be required to pass a fingerprint-based background check.

The incumbent in this position will work with and provide support to a diverse customer base and must be able to interact in a non-partisan manner.