INTRA-DEPARTMENT - Claims Manager

INTRA-DEPARTMENT

JOB OPENING

CITY OF FARMINGTON

JOB POSITION #38: CLAIMS MANAGER

NUMBER OF VACANCIES:  1

DEPARTMENT: Administration/Legal

WORK LOCATION:  City Hall

HIRING RANGE:  $48,866.1763 to $74,448.4291

PAY GRADE:   M Exempt

TYPE OF POSITION:  Regular, Full-Time

DAYS WORKED: Monday to Friday

HOURS WORKED: 8:00AM to 5:00PM

APPLICATIONS RECEIVED UNTIL: Friday, March 16, 2018 

JOB DUTIES 

ESSENTIAL DUTIES:

Claims Manager performs a variety of routine and complex administrative; technical and professional work in coordinating, investigating, and administering lawsuits and claims against the City of Farmington and collecting monies owed the City of Farmington for damaged City property. 

Maintains a very high degree of confidentiality.

Works under the general supervision of the City Attorney's Office. 

Actively investigates all claims in good faith; makes fair and impartial decisions regarding their validity; makes diligent efforts to settle meritorious claims; avoids litigation when possible; and vigorously defends those cases which are determined to be non-meritorious.

Works directly with all City employees, supervisors, and department heads to provide support, information, advice, and education on minimizing claim and lawsuit liability, insurance policy interpretation, and issues regarding public safety.

Administers, coordinates, and continually monitors City of Farmington insurance policies.  Maintains thorough up-to-date knowledge of the policy provisions and how they are used.  Submits claims to correct insurance company when the City has a reportable claim.  The City's insurance policies include: Property (Non-Utility) Insurance; Farmington Electric Utility Property Insurance; Liability (Multi-Lines) Insurance; Airport Liability Insurance; Auto Liability Insurance; Boiler and Machinery Insurance; Fine Arts Insurance; Pollution and Professional Liability Insurance; Umbrella Excess Liability Insurance; Accidental Death & Dismemberment Volunteer Insurance; and Crime Insurance. 

The City of Farmington is considered self-insured.  The City has an excess insurer that assists with claims or lawsuits once the payments exceed $500,000.  Even with excess insurance assistance, the Claims Manager is responsible for handling the claim or lawsuit to conclusion. 

Responsible for receiving, investigating, and resolving all claims, lawsuits, and collections (handle to conclusion).  Communicates and provides guidance while coordinating claim, lawsuit, and collection activities with the involved City Departments and Divisions.  Position requires a very high degree of problem solving with the ability to amicably resolve disputes. 

Must be competent and proficient in using computer applications including word; excel; downloading, saving and printing photos; email applications; scanning and saving documents; on-line claims or litigation research; City of Farmington financial computer software; and Law Enforcement New World software. 

Maintains up-to-date and thorough knowledge of the New Mexico Tort Claim Acts, and New Mexico State Statutes (litigation, utility liability, contract liability, traffic laws, statute of limitations, etc.) and how they apply to claims, litigation, and collections.

Follows and adheres to guidelines set for the City's Claim Payment Authority Policy.  Prepares formal evaluations, which document the City's levels of authority process.      

Responsible for receiving notice of claims; distributing notice of claim to appropriate City personnel; investigating claims; establishing reserves; ascertaining monetary damages; negotiating settlements; and coordinating/directing the City's outside attorney litigation. 

Claims Manager calls upon the expertise and knowledge of the City's attorneys, private law firms, independent adjusters, experts, or other resources as needed to advise the City of its responsibility for the claim or lawsuit. 

Properly documents all claims files (electronic and paper) for fiscal, financial audits, and legal purposes. 

If the Claims Manager after investigation finds a claim is without merit, the claimant shall be notified in writing (dependent on the severity and circumstances of the incident leading to the claim) with an explanation of the reasons for denial. 

Participates and evaluates RFP (request for proposal) Purchasing Department process every four years to select outside law firms to represent the City of Farmington for legal counsel and litigation management. 

Evaluates outside attorney qualities and their expertise to handle incoming lawsuits. 

Receives properly served summons for lawsuits against the City.  Distributes the complaint and summons to appropriate City personnel.  Makes outside attorney recommendation for lawsuit to City Attorney and appropriate Department Head (dependent on the attorney's expertise and current caseload with the City).    

Provides Case Management Format to all outside attorneys when new lawsuits are assigned.  Each outside attorney is responsible for providing case management updates to the Claims Manager.  The Claims Manager reviews and approves the quarterly case management plans. 

Coordinates and furnishes lawsuit discovery requests to our outside attorneys.  Makes sure appropriate City personnel are copied on all lawsuit documents.  Makes sure that paper file and electronic files contain all litigation documents.  Knows how to access Federal and State Court web sites for lawsuit updates. 

City of Farmington's representative for all litigation matters.  Claims Manager presents a competent, professional, and authoritative presence at all times in representing the City.  May attend court ordered settlement conferences or mediations.  May attend pre-trial hearings and depositions held in the City of Farmington.  May attend lawsuit trials wherever the case is heard.  Claims Manager and City Attorney discuss and approve experts requested for lawsuits. 

Has working knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, and agency rules, HIPAA health laws and regulations, Medicare regulations, and has ability to handle complex claims and litigation.

Responsible for entering all claim and litigation payments using the City's financial software.  Requests approval authority from the appropriate City personnel so claim and litigation checks can be issued.  Prepares appropriate documents supporting claim or litigation payments to the City's Finance Department, insuring the payment is properly documented for auditing purposes. 

Audits all outside attorney fees and costs making sure they are reasonable and necessary.  Makes recommendations to outside attorneys to save defense costs.  

Medicare Account Designee for all claims and litigation involving a claimant or plaintiff whose medical expenses have been paid by Medicare.  Responsible for setting up Medicare claim.  Has access to Medicare secure and restricted web site for entering and following Medicare claim process.  Coordinates and makes sure Medicare is reimbursed for claims and litigation involving claimants and plaintiffs where the City was responsible for their injuries. 

Claims Manager is responsible for submitting the Claim Division's budget on an annual basis.  

Provides quarterly narrative report for all lawsuits and written tort claim notifications and claims spreadsheets to Department Heads, City Manager, Legal Department, Mayor, Council, excess insurer, and agent of record. 

Provides loss runs and updated narrative report for all lawsuits and tort claim notifications to excess insurer in preparation for site audits and annual insurance renewals.  When excess insurer requests an onsite audit Claims Manager prepares and coordinates the onsite audit.  

Prepares annual claims, lawsuits, and collections detailed report to City departments and divisions, excess insurer, and agent of record at the end of each calendar year. 

Prepares Incurred but Not Reported spreadsheets, statistics, and lawsuit and tort claim narrative to the Finance Department for City audits. 

Prepares fiscal year spreadsheets for Management of American Cost Allocation evaluations. 

Claims Manager initiates communication with individuals and companies for damage recovery on damaged City property.  Obtains necessary information and writes reports in order to file claims with insurance carriers and claims departments.  Insures that collection of damages is carried out to include soliciting official legal interaction which may include filings in District or Magistrate Court.

Using excellent customer service skills establishes and maintains effective working relationships with other employees, officials, attorneys, and all members of the general public. 

Ability to prioritize work while paying attention to detail; ability to carry out job duties to their completion with minimal supervision; and ability to work independently with a multitude of tasks. 

Attendance at work is an essential function of this position.  

NON-ESSENTIAL DUTIES:

May serve on various employee committees, as required and assigned.

May be required to travel to attend seminars and conferences to keep up to date on issues, trends, and required compliance to laws. 

The duties listed above are intended only as illustrations of the various types of work that may be performed.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to the position.

QUALIFICATIONS

This position is subject to the City of Farmington's Drug and Alcohol Free Workplace Policy.

High school diploma or equivalent required.  Graduation from an accredited four year university with a business related degree preferred or a minimum of four (4) year of prior insurance claims adjusting preferred or a respective combination of education and experience equivalent to perform duties listed.

Strong background in records maintenance preferred.  Ability to compile and maintain case and claim files with appropriate documentation. 

Must be bondable as an Insurance Adjuster through the State of New Mexico and maintain bonding and state issued licensing on an ongoing basis.

Working knowledge of the legal and police system as it pertains to insurance claims and adjusting is required.

Keeps informed and up to date on claim management concepts, practices, and procedures. 

Ability to communicate effectively both verbally and in written form. 

Ability to establish and maintain professional and effective working relationships with employees, supervisors, other departments, and external entities each of which require cooperative efforts on both sides. 

Ability to compose accurate, timely and professional correspondence to all parties associated with claims related to the City.

Ability to respond to callout situations after hours, on weekends, and holidays.

Valid New Mexico driver's license required.

Ability to establish and maintain cooperative, problem solving relationships with individuals who must make restitution to the City and those who have claims against the City.

Must maintain the highest ethical standards while representing the City on claim settlements and case investigations.

Ability to maintain and ensure the confidential nature of the Claims Division and Legal Department and their records. 

Ability to operate tools and equipment listed.

TOOLS AND EQUIPMENT USED:

Ability to operate with proficiency a personal computer with work related software, calculator, telephone, copy machine, scanner, fax machine, motor vehicles, and digital camera.

PHYSICAL DEMANDS:

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

While performing the duties of this job, the employee is frequently required to stand; walk; grasp; pick up; feel or operate objects, tools or controls; reach with hands and arms; sit; climb or balance; stoop, kneel, crouch or crawl; talk, hear, and smell.  Specific vision abilities including close and distance vision and ability to focus. 

The employee must frequently lift and/or move up to 25 pounds. 

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Work is performed primarily in an office environment.  However, while performing the duties of this job, the employee occasionally works near moving mechanical parts and in outside weather conditions.

The noise level in the work environment is usually moderately quiet. 

WE ARE AN EQUAL OPPORTUNITY EMPLOYER, M/F.

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