Insurance Claims Supervisor GL (State Risk Adjuster 5)Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4749647) ApplyInsurance Claims Supervisor GL (State Risk Adjuster 5)Salary $3,904.00 - $7,658.00 MonthlyLocation Baton Rouge, LAJob TypeClassifiedJob NumberORM 120424 ERGDepartmentDivision of Administration-Risk ManagementOpening Date12/04/2024Closing Date12/15/2024 11:59 PM Central
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Supplemental InformationThe Division of Administration/Office of Risk Management has a vacancy. This job title has an assigned pay grade of AS-617. This vacancy will be filled by new hire or by promotion of a current permanent status classified employee. Louisiana is a "State as a Model Employer" for People with Disabilities. There is a Special Entrance Rateof $1,953.60 biweekly for this position. A criminal history check may be conducted on all new hires as well as employees changing positions including promotions, demotions, details, reassignments and transfers. Also, prospective employees may be subject to pre-employment drug testing. New hires will be subject to employment eligibility verification via the federal government's E-verify system. No Civil Service test score is required in order to be considered for this vacancy. To apply for this vacancy, click on the “Apply” link above and complete an electronic application which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the information section of the Current Job Opportunities page. Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete. Applicants qualifying based on college training or receipt of a baccalaureate degree will be required to submit an official college transcript to verify credentials claimed prior to appointment. Please make every effort to attach a copy of your transcript to your application. The transcripts can be added as an attachment to your online application or faxed to (225) 219-1041. The selected candidate will be required to submit original documentation upon hire. For further information about this posting, please contact:Erica R. Gay HR Specialist Division of Administration/Office of Human Resources email: Erica.Gay@la.gov Minimum QualificationsMINIMUM QUALIFICATIONS:A baccalaureate degree plus three years of professional level experience in insurance claims adjusting, nursing, allied heath fields, construction management, or as a practicing attorney.SUBSTITUTIONS:A master's degree in business or public administration, finance, accounting, statistics, insurance or risk management, safety or legal studies, nursing, allied health fields or construction management will substitute for one year of the experience.Experience in the fields of accident investigation, insurance claims examining, insurance claims investigation or insurance claims adjusting will substitute for the required college training on the basis of 30 semester hours for one year of experience.NOTE:This substitution allows any combination of experience and college hours to substitute for the baccalaureate degree. Thirty semester hours of college training is accepted as equivalent to one year of work experience, and college credit in increments of fewer than 30 hours is prorated on this basis.NOTE:Any college hours or degree must be from an accredited college or university.Job ConceptsFUNCTION 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.LOCATION OF WORK:Division of Administration and the Office of the Governor.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.Examples of WorkThe Office of Risk Management (ORM) is the Division of Administration ancillary agency that administers the comprehensive risk management program for the State of Louisiana and is solely and statutorily responsible for managing all state insurance coverage, both purchased and self-insured, for workers’ compensation, property, and casualty exposures. ORM is responsible for managing all tort claims made against the State and department/agency/board/commission clients; and also serves as the State of Louisiana public facilities sub-recipient representative for FEMA Public Assistance Grants.ORM State Risk Adjuster 5 positions are supervisory, and employees work in one of three Casualty Claim Units, or in the Property Claims Unit. Personnel report to and receive administrative direction from the unit manager, a State Adjuster 6. The vacant position is in the Casualty Claim - General Liability Unit, where lines of coverage include premises–operations, public officials, professional, employment practices, personal injury, media and civil/constitutional rights.Duties and responsibilities include, but are not limited to: Responsible for the comprehensive overview of all claim handling and management activities for claims, exercising first-line functional supervision over the State’s Third Party Administrator (TPA). Oversees work processes; reviews and approves or denies transactions that exceed authority levels delegated to TPA. Monitors and reviews the work of TPA desk examiners and claim adjusters. Exercises contract oversight, utilizing performance standards and guidelines in evaluating claim files and conducting performance reviews of the TPA and its employees. Develops and executes periodic in-depth file and performance reviews for a sufficient number of TPA claim files to ensure the adjudication of claims in compliance with TPA's contract terms. Examines and evaluates the handling and disposition of non-litigated claims involving, but not limited to, the level and extent of claim investigation, the assessment of liability, and settlement method or denial by the TPA. Receives and reviews Petitions, performs risk matter reviews, and processes Petitions to the Attorney General for legal opinions and assignment of defense counsel. Participates in team meetings and staffings with the Attorney General's Office, the TPA, and ORM personnel to discuss strategies and defense of the case. May attend mediations and trials, if warranted. Reviews claims involving litigation to ascertain whether defense counsel and TPA have conducted sufficient investigative activities. Assesses and evaluates if defense counsel has conducted appropriate discovery and is pursuing defense unique to the State. Obtains legal opinions and case evaluations from defense attorneys, especially in cases requiring legal interpretation and/or posing major financial losses to the State. Prepares and submits completed case analysis of State's liability with settlement recommendations to appropriate claims level and or Claims Council. Serves as a voting member of claims council, which authorizes claims settlements up to a limit of $5,000,000. Authorized to extend individual payment and settlement authority of $100,000 without additional approvals. Direct authority to increase total claim reserves up to and including $500,000 and to approve contract amendment requests up to $100,000 without additional approvals.Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity tomake a differencethrough public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career. As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:Insurance Coverage More information can be found at https://info.groupbenefits.org/Parental Leave– Up to six weeks paid parental leaveMore information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspxHolidays and Leave – State employees receive the following paid holidays each year:
New Year's Day
Martin Luther King, Jr. Day,
Mardi Gras,
Good Friday,
Memorial Day,
Independence Day,
Labor Day,
Veteran's Day,
Thanksgiving Day and Christmas Day.
Additional holidays may be proclaimed by the GovernorState employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):
Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video (https://lasersonline.org/wp-content/uploads/2016/07/YourRetirementSystem.mp4) to give you more detailed information about their system
Teacher's Retirement System of Louisiana (www.trsl.org),
Louisiana School Employees Retirement System (www.lsers.net), among others
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Identify the type of insurance claims have you handled.
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Explain duties and responsibilities, providing specifics and details of actual work performed.
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Describe any prior experience you have overseeing litigation management, including your interaction with defense counsel, authorizing defense budgets and/or settlement requests. If no experience, write "NA."
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Describe any experience (whether or not specifically related to insurance claims) you have with either holding a position of file reviewer or being assigned file review tasks. Provide specifics and details of actual work performed. If no experience, write "NA."
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Have you ever supervised a claim adjusting service and/or a TPA (Third Party Administrator)? If yes, please explain your role and responsibilities.
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Do you have any experience auditing invoices and/or claim files? If yes, please explain.
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Describe your familiarity with insurance policies and coverage analysis. Be detailed and specific.
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The ability to provide clear, concise, and professional written and verbal communication is essential for this position. Explain how your communication abilities have effectively aided you in your current or previous positions, providing example(s) and details.
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Please, review your application one more time to confirm it is accurate and complete. We cannot consider prior work experience or other relevant information omitted from the application when evaluating your qualifications for employment. Did you list ALL your job experience and education on your application?
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AgencyState of LouisianaAddressFor agency contact information, please refer tothe supplemental information above.Louisiana State Civil Service, Louisiana, 70802Phone(866) 783-5462Websitehttp://agency.governmentjobs.com/louisiana/default.cfmApplyPlease verify your email addressVerify Email
