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Claims Adjuster-Examiner

OPENING/CLOSING DATE:  September 16, 2019 until filled

SUBMIT RESUMES TO:  jobsearch@omag.org 

SUMMARY OF POSITION:

Investigate claims of general liability and property programs.

ESSENTIAL JOB FUNCTIONS

A.1 Communicates with client (OMAG), insured (city/town) and claimant regarding claim process

A.2 Reviews coverage as confirmed by Director of Claims

A.3 Investigates claims to ascertain liability

A.4     Handles requested research/investigations for legal counsel

A.5     Negotiates settlement of claims up to designated authority levels

A.6     Drafts coverage disclaimers, status reports, payment letters, claims summaries for legal counsel

A.7     Monitors progress of each claim and revises reserves as necessary and indicated

A.8     Obtains police reports, medical records, weather records, etc.

A.9     Run ISO searches as necessary

A.10    Report total losses to ISO as necessary

A.11     Determine need for independent appraisals and make assignments for same

A.12    Maintain diary for review on all claims

A.13    Enters payment information and reserve information into system

A.14    Obtain signed releases and request settlement checks and closing letters to cities and towns

A.15    If liability determination is to recommend denial, prepares and sends denial recommendation letters
to the claimant and city/town.

A.16    Identify and pursue third party (subrogation) claims

A.17     Attend monthly Claims Department meeting.

A.18    Identify and pursue salvage and recoveries

A.19    Notify Director of Claims of any potential excess/reinsurance files

A.20   Reports to Director of Claims and Claims Supervisor

ESSENTIAL RESPONSIBILITIES

B.1      Consistently demonstrate accountability for proper job performance, showing competency and
understanding of job responsibilities to further the goals and objectives of the organization. 

B.2     Exercise good judgment and initiative in seeing work to be done and doing it. 

B.3     Maintain technical and/or professional proficiency in primary area of responsibility, demonstrating
responsibility for self-development, striving to continuously stay informed regarding new ideas and
procedures applicable to specific area of responsibility. 

B.4     Use equipment and supplies in a safe and economical manner, reporting needs for repair and/or
replacement to the appropriate individual in a timely manner. 

B.5     Demonstrate ability to establish priorities regarding work responsibilities and to adjust to new
circumstances or ideas as well as changing needs of the department and organization. 

B.6     Establish and maintain positive working relationships with supervisors, co-workers, Board members,
municipal representatives and the public, striving to keep open communication at all times. 

B.7     Show support and respect for the organization, its people and policies, to municipalities, vendors,
visitors and other individuals in the workplace. 

B.8     Discuss concerns or disagreements regarding policies, goals or decisions with the appropriate
individual in a manner which assists in problem solving.

 B.9    Demonstrate an attitude of cooperation, open-mindedness and flexibility regarding resolution of
disagreements or problems.

EXPERIENCE, KNOWLEDGE, LICENSES AND CERTIFICATIONS REQUIREMENTS

  • High school graduate or (GED) required

  • Bachelor’s degree from accredited college preferred

  • CPCU, ARM, AIM and/or AIC certifications preferred

  • Experience using word processing programs and performing data entry in claims management software, preferably RISKMASTER® Accelerator.

EXPERIENCE, KNOWLEDGE, LICENSES AND CERTIFICATIONS PREFERENCES:

  • Ability to exercise good judgment observing scope of authority and maintaining confidential information regarding claims.

  • Proficiency in all applicable hardware and software, demonstrating accuracy and understanding of proper equipment operations.

  • Proficiency in other basic clerical skills such as filing, answering the telephone and operating routine office equipment.

  • Ability to concentrate and perform accurate operations for sustained periods of time.

  • Understanding of good public relations and communication skills regarding telephone conversations and ability to deal positively with a variety of individuals.

  • Proficiency and accuracy in data entry functions.

PHYSICAL COMMUNICATION REQUIREMENTS:

(The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.)

  • Ability to talk and/or hear. (talking – expressing or exchanging ideas by means of spoken words; hearing – perceiving nature of sounds by ear).

  • Ability to physically communicate via telephone and in person

INTERPERSONAL COMMUNICATION REQUIREMENTS:   

  • Ability to speak and/or signal people to convey or exchange information. Includes receiving assignments and/or directions from supervisor as well as giving assignments and directions to those supervised.

  • Ability to read a variety of reports, applications, messages, letters, informational documentation, directions, instructions, and methods and procedures.

  • Ability to prepare forms, reports and letters using prescribed formats and conforming to all rules of punctuation, grammar, diction, and style.

MOTOR COORDINATION REQUIREMENTS: 

  • Ability to coordinate hands and eyes in using a computer and other office machines.

  • Ability to use a variety of items, such as a telephone switchboard, printers, boxes and cartons of supplies, etc.

INTERPERSONAL TEMPERAMENT REQUIREMENTS: 

  • Ability to use tact, diplomacy, and establish positive working relationships with individuals in a wide variety of municipal positions.

  • Must be adaptable to performing under minimum stress when confronted with an emergency.

SELECTION GUIDELINES

Formal application, rating of education and experience; oral interview and presentation; and reference check. 


OMAG Benefits

By joining the staff at OMAG you’ll have the opportunity to do something positive for the cities and towns of Oklahoma.  We take our mission to be the premier insurance provider for Oklahoma municipalities seriously. That includes providing extensive value-added services that range from education and training to legal and technical assistance and loss control and risk assessment, as well as dependable, fair and efficient claims handling. We believe the most valuable asset we provide is to make municipal insurance understandable, effective and affordable and to do so through our outstanding customer service.

OMAG is an Equal Opportunity Employer
 

Benefits provided by OMAG include:

  • OMAG pays 100% of the Health, Life, Dental and Vision insurance for employees

  • OMAG pays 100% of the Health, Life, Dental and Vision insurance for family coverage, if necessary

  • Section 125 Cafeteria Plan for unreimbursed medical cost

  • Long-Term Disability (optional)

  • 10 Paid Holidays per year

  • 24 hours of PTO for the first 6 full pay periods

  • Vacation Leave, accrued biweekly, depending on years of service

  • Sick Leave of 12 days per year, accrued biweekly, maximum accrual of 720 hours

  • Defined Contribution Retirement Plan OMAG contribution of 17% of salary (5-year vesting)

  • Section 457 deferred compensation plan (optional)

  • Employee Assistance Program

  • Phone allowance $34.15 per pay period (exempt employees only)

  • Gym membership reimbursement up to $500 per year

  • 16 hours of Community Service Leave per year

  • Maternity/Paternity leave up to 40 hours for birth or adoption of a child

  • Tuition Assistance Program up to $5,250 per calendar year

The actual terms of these benefits, and any others, are governed by OMAG’s Personnel Policies as set forth in its Procedures Manual, a copy of which will be provided to you upon commencement of employment.

To apply for a position, email your resume and cover letter to jobsearch@omag.org, or call Suzanne Paulson at (405) 657-1444.