Job Title: Claims Representative

Reports to:Manager, Claims Administration
Typical Schedule:245 days/7.5 hours
Bargaining Unit:USEP INS

 

FLSA:Non-Exempt
Job Code:5195
Salary Schedule:70N

JOB GOAL

Under general supervision, responsible for performing specialized, varied, complex duties related to claims administration. This includes coordinating with other departments in preparing and submitting detailed documentation and maintenance of databases and reports, particularly relating to the administration of workers’ compensation, student athletic insurance and liability claims.

ESSENTIAL DUTIES & RESPONSIBILITIES

The following statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. These statements are not intended to be construed as an exhaustive list of all duties and responsibilities required of those in this position.
  1. Organize and coordinate activities related to workers’ compensation, liability, student athletic programs and other insurance and risk management programs.
  2. Provide input and assist with creation, modification and implementation of risk management processes to improve department efficiency and better serve stakeholder needs.
  3. Update and maintain records within the claims administration system.
  4. Manage and update department website information and links.
  5. Respond and resolve inquiries related to risk management and claims administration in a timely manner.
  6. Respond proactively to incoming incident/accident reports and provide investigative materials to adjusters.
  7. Maintain electronic calendars for multiple risk management programs.
  8. Create educational materials related to risk management and claims administration.
  9. Coordinate and assist with group/individual training classes.
  10. Design forms based on procedures.
  11. Develop and prepare a variety of ad hoc reports for ongoing administrative needs.
  12. Coordinate and schedule meeting rooms and set up required equipment.
  13. Provide backup for department staff and assist as needed.
  14. Perform other duties as assigned.

MINIMUM REQUIREMENTS

Requirements are representative of minimum levels of knowledge, skills and/or abilities. To perform this job successfully, the incumbent will possess the abilities or aptitudes to perform each duty successfully. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

KNOWLEDGE, SKILLS & ABILITIES

  • Excellent organization skills
  • Ability to understand basic claims and insurance processes
  • Ability to understand federal, state and local district reporting requirements, regulations and procedures
  • Advanced knowledge of spreadsheets and other software programs including calendar management, email, word processing, presentation software and databases
  • Ability to maintain accuracy of data in systems
  • Ability to communicate effectively with a variety of audiences, orally and in writing, including electronic media
  • Ability to organize, prioritize, manage and carry out duties efficiently and within established timeframes
  • Ability to establish and maintain collaborative working relationships with all stakeholders

EDUCATION, TRAINING & EXPERIENCE

  • Associate degree or equivalent (2 years of college coursework)
  • Previous experience in an office environment
  • OR
  • Any equivalent combination of education and experience which provides the required knowledge, skills, and abilities to perform the essential duties and responsibilities of the position

CERTIFICATES, LICENSES & REGISTRATIONS

None

PREFERRED QUALIFICATIONS

  • Experience in insurance, legal, or related field

SUPERVISORY RESPONSIBILITY

None

PHYSICAL REQUIREMENTS

Sedentary: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull or move objects. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

PHYSICAL ACTIVITY

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.

While performing the duties of this job, the employee is required to sit, talk and hear; stand and walk; use hands to finger, handle, or feel; reach with hands and arms. The employee occasionally lifts and/or moves up to 25 pounds. Specific vision ability required by this job includes close vision, distance vision, and the ability to adjust focus.

WORKING CONDITIONS

Indoors and Outdoors: The worker is subject to both environmental conditions. Activities occur inside and outside.

MACHINES, TOOLS, EQUIPMENT

  • General office equipment, including personal computers, fax machines, copiers, telephones, etc.

TERMS OF EMPLOYMENT

Salary and benefits shall be paid consistent with the District’s approved compensation plan. Length of the work year and hours of employment shall be established by the District.

Performance of the job will be evaluated in accordance with provisions of the School Board’s policy on evaluation of personnel.

Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

Pasco County Schools will provide reasonable accommodations to qualified individuals with disabilities to allow them to perform the essential functions of the job when such individuals request an accommodation.

Claims Representative;   EST: February 17, 2017 ;   REV: June 23, 2020;   Board Approved: February 17, 2017