Claims Adjuster

Job Description:

Claims Adjuster

Description

Grade 18 - Starting Annual Salary: $55,037.00. Rate of pay depends on qualifications.

Job Description

JOB SUMMARY
The Claims Adjuster is responsible for investigating, evaluating, reserving, negotiating, and settling property, casualty, or workers' compensation claims in accordance with Best Practices and in compliance with all City, State, and Federal regulatory laws. This position promptly and equitably resolves claims to minimize SAWS' liability and reduces overall claims costs.

ESSENTIAL FUNCTIONS

• Adjust claims, to include handling workers' compensation, liability and subrogation claims for SAWS.
• Investigates all relevant facts and evaluates findings to determine coverage, negligence, and liability issues for each claim submitted to SAWS.
• Researches historical evidence through review of service requests, work orders, maps, emails, statements, medical reports, appraisal reports and other technical means.
• Establishes appropriate reserves based on the estimated probable cost of the claim with the proper file documentation to explain the rationale behind the computation.
• Issues payments in a timely manner to claimants and vendors in accordance with all regulatory standards and laws.
• Negotiates claim settlements for monetary recoveries for damages to SAWS' assets.
• Documents claim file activities in accordance with established procedures.
• Prepares claims narrative report(s) for documentation purposes outlining the facts of the case, applying the applicable sections of the Texas Tort Claims Act and a recommendation on claim resolution.
• Communicates effectively, written and orally, with customers including, but not limited to claimants, witnesses, employees, attorneys, medical professionals, governmental entities, and contractors.
• Determines the value and extent of related damages and/or workers compensation injuries by verifying support documentation and reviewing medical bills.
• Performs other duties as assigned.

DECISION MAKING

• The Claims Adjuster receives general supervision.

MINIMUM REQUIREMENTS

• High School Diploma or GED.
• One year's experience investigating, evaluating, reserving, negotiating, and settling claims. Experience should be in one or more of the following claims disciplines: workers' compensation, casualty (auto & property), appraising, personal injury and/or subrogation.
• State of Texas Multi-Line Claims Adjusters License as required by TIC 4101 or the ability to acquire a license within six [6] months of hire.
• Valid Class "C" Texas Driver's License.

JOB DIMENSIONS

• Knowledge of general negligence principals and their application within governmental community in particular the Texas Tort Claims Act.
• Skill in using a computer and job related applications.
• Skill in using various Risk Management Information Systems to document claim activity and maintain claim diary system.
• Ability to analyze a proof of loss and/or property appraisal to determine actual cash value owed to claimants.
• Ability to maintain and submit accurate records within the required time periods.
• Ability to estimate time and materials needed for projects.
• Ability to maintain confidential information.
• Ability to perform all the physical requirements of the position.
• Ability to communicate clearly and effectively, both verbally and in writing.
• Ability to establish and maintain effective working relationships with staff, management, property owners, vendors, and governmental agencies.

PHYSICAL DEMANDS AND WORKING CONDITIONS
Physical requirements include lifting up to 20 pounds occasionally. Subject to sitting for long periods of time to perform job scope. Occasionally subject to standing, walking and climbing. Requires visual acuity, speech and hearing. Working conditions are primarily in an office environment, with occasional field visits requiring operation of company/personal vehicle.

May be required to work hours other than regular schedule such as days, nights, weekends, holidays, and flexible work schedule.

San Antonio Water System values the contributions of all its employees, providing them the best in compensation and benefits. The benefits package is designed to attract and retain a workforce of qualified employees who share a responsibility in providing quality water to 1 million consumers.
From an affordable medical and dental plan to life-sustaining retirement and insurance plans, we offer benefits that reward employees for their commitment to a challenging career at SAWS. Employee benefits include the following:

• Competitive, market-based salaries
• Performance-based incentives
• Medical benefits
• Dental benefits
• Life insurance
• Prescription drug program
• Vision care plan
• Two retirement plans
• Deferred compensation plans (457 plan)
• Disability income
• Paid leave (vacation, sick, personal)
• Education assistance program
• Employee assistance program
• Flexible, tax-deferred health and dependent care spending accounts
• Wellness programs
• On-Site Fitness Facilities
• Community service opportunities

Closing Date/Time: 1/19/2025 11:59 PM Central

Salary:

$55,037.00 - $94,411.00 Annually