Claims Consultant
Purpose Statement
The job of Claims Consultant is done for the purpose/s of evaluating, negotiating, and resolving property and casualty claims, including high complexity school law claims; and serving as a resource to others.
This job reports to either Deputy Executive Director, Director of Claims and Litigation, or Manager of Claims and Legal Affairs as designated by management.
Essential Functions
• Administers and resolves complex property and liability claim files (e.g. confirming coverage, setting proper reserves, completing field investigations, determining eligibility, attending mediation and arbitration, managing litigation, negotiating settlements with claimants, authorizing payments within prescribed authority, etc.) for the purpose of ensuring quality claim handling and service to member districts within policies, procedures, and budgets.
• Authorizes procurement card purchases up to $500 for the purpose of ensuring expenses are within defined budget limits and/or fiscal practices are followed.
• Authorizes claims payment within assigned authority for the purpose of meeting WSRMP Targeted Strategies.
• Collaborates with other Teams for the purpose of addressing prevention and training issues.
• Communicates with Management, related departments, member district personnel, experts, claimants, attorneys, and other outside organizations for the purpose of coordinating investigations and activities, responding to inquiries, exchanging information, and resolving claims and lawsuits.
• Develops and provides claims-based training to member districts in School Board meetings or regional training sessions for the purpose of educating the member districts on issues of coverage, liability, and adjustment procedures.
• Embodies the principles and practices that form our culture and commitment to Diversity, Equity, Inclusivity, and Belonging needed to meet the WSRMP’s Mission and Targeted Strategies.
• Identifies and reports by Captioned Report catastrophe-level claims to management for transmittal to the Board and/or reinsurers for the purpose of procuring settlement authority.
• Maintains a variety of manual and electronic documents, files, and records (e.g. claim file, litigation file, claim diary, electronic claim notes, etc.) for the purpose of documenting claim activities in accordance with guidelines.
• Manages complex litigated claim files including monitoring discovery, directing activities of defense counsel, attending mock trials, mediations, legal motion, and trials for the purpose of ensuring appropriate litigation management, legal cost management, claim resolution, and setting of proper reserves.
• Oversees claim file reserves (e.g. initial reserves, reserve adjustments based upon material changes in liability or damages, formal reserve reviews, limiting reserve redundancy, etc.) for the purpose of setting realistic funding levels within budget and in compliance with established regulations.
• May utilize a fleet or personal vehicle for the purpose of performing the essential functions of the position.
Other Functions
• Assist other personnel as may be required for the purpose of ensuring an efficient and effective work environment.
• Attend in person activities, meetings, and conferences as directed by management.
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