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Description Under limited supervision, performs a variety of tasks associated with the Risk Management Program. ESSENTIAL FUNCTIONS: Essential functions, as defined under the Americans with Disabilities Act, may include the following tasks, knowledge, skills and other characteristics. This list of tasks is ILLUSTRATIVE ONLY, and is not a comprehensive listing of all functions and tasks performed by incumbents of this class.

Tasks Receives and processes claims associated with the Risk Management program; ensures proper loss/injury report forms are completed by departments; establishes and maintains claims files for property, liability and on-the-job injury claims; acquires repair estimates, police reports, incident reports, medical reports and witness statements as needed; schedules medical appointments as needed; obtains and reviews medical notes; processes medical and prescription bills associated with work-related injuries and illnesses in conjunction with County's claims administrator; monitors employee return-to-work status and ensures compliance with associated work restrictions through supervisory personnel; reviews and processes claims administrator bills and associated claims payments. Position requires ability to work independently, and coordinate claims activity with County personnel, County claims administrator, medical provider personnel and other contacts in the fulfillment of assigned duties. Maintains appropriate files, records and logs in compliance with risk management, TOSHA, OSHA, and other regulatory requirements; calculates and sets appropriate reserves for claims; provides claim status updates to risk management, supervisory, and other appropriate staff; provides clerical support for the risk management staff; enters and maintains data in the risk management information system (RMIS); responds to and researched inquiries regarding claims; works with third-party vendors to reconcile problems/concerns with unpaid invoices; may receive and process certificates of insurance (COI).

Analyzes data and develops reports summarizing claims activity associated with the County risk management program; complies quarterly loss reports for and for the County; responsible for completing the detailed year-end actuarial report, and other reports as needed; maintains a list of County buildings and other assorted property lists. Tracks and calculates employee indemnity pay for employee lost time claims; may participate in defense preparation with County attorneys and various departments; may conduct and oversee investigations into suspicious/questionable claims at the direction of senior management. Performs other related duties as assigned to support the daily operation of the Risk Management Office.

Knowledge, Skills, Abilities, and Other Characteristics Knowledge of Risk Management policies, programs and operating procedures. Knowledge of relevant Hamilton County policies and procedures. Knowledge of office administration principles, computer applications and general claims processing requirements.

Knowledge of Risk Management Information Systems (RMIS) or other claims/case management software. Knowledge of medical, legal, or other technical terminology that may be related to claims handling. Knowledge of investigative tactics, techniques, tools, procedures, related laws, etc.

Skill in reading, interpreting, understanding and applying departmental and Hamilton County policies and procedures. Skill in organization, prioritization, and time management. Skill in administering claims procedures.

Skill in communicating effectively orally and in written documents and reports. Skill in Microsoft Office including PowerPoint, Word, Excel, and Outlook. Skill and proficiency in data entry.

Skill in the use of personal computer and related software. Skill in establishing and maintaining effective working relationships. Skill in verbal and written communication including letter composition.

Skill in maintain a calendar, hosting meetings, and making presentations if needed. Ability to operate most standard office equipment. Ability to develop and maintain spreadsheets.

Ability pay attention to detail when composing, typing and proofing materials, establishing priorities, and meeting deadlines. Ability to maintain a high level of confidentiality when handling confidential information and situations. Ability to apply consistent courtesy and tact while in contact with the public and/or confrontational situations.

Ability to be adaptable to performing under frequent deadlines and/or in response to emergencies. Apply use sound judgment and interpretation based on acquired knowledge in circumstances where limited standardization exists. Ability to express ideas clearly and concisely, orally and in writing.

Ability to effectively explain technical claims problems or procedures in simple, non-technical language when necessary. Ability to maintain effective and cooperative working relationships with employees, County departments, attorneys, physicians, investigators, external agencies and other parties. Ability to detect and evaluate discrepancies in claims reporting and investigate when warranted.

Ability to read a variety of materials relevant to government, legal, and County administration operations that range from moderate to complex levels. Ability to Analyze and interpret problems, and draw valid conclusions in task processing and prioritization. Ability to add, subtract, multiply and divide and calculate decimals and percentages.

Ability to inspect items for proper length, width and shape, and visually read various types of information. Minimum Qualifications A Master's Degree in Business Management, Risk Management, Human Resources, Public Administration or closely related field and one (1) year of direct work experience related to, claims administration, risk management-related programs, business management, or a closely related field. A valid driver's license is required.

OR A Bachelor's Degree in Business Management, Risk Management, Human Resources, Public Administration or closely related field and three (3) years of direct work experience related to, claims administration, risk management-related programs, business management, or a closely related field. A valid driver's license is required. OR An Associate's Degree in Business Management, Risk Management, Human Resources, Public Administration or closely related field and five (5) years of direct work experience related to, claims administration, risk management-related programs, business management, or a closely related field.

A valid driver's license is required. OR The equivalent of a high school diploma and seven (7) years of direct work experience related to, claims administration, risk management-related programs, business management, or a closely related field. A valid driver's license is required.

PREFERRED QUALIFICATIONS: Previous work experience in a Human Resources Department or Risk Management is preferred but not required. Previous work experience in a lead or supervisory role is preferred but not required. Previous work experience in the field of Law is preferred but not required.

Current Tennessee Certified Claims Adjuster, or the ability to become certified is preferred but not required. Liability or work injury claims adjustor work experience is preferred but not required. Direct work experience in accounts payable or basic accounting is preferred but not required.

PHYSICAL REQUIREMENTS: Work involves sedentary and routine keyboard use, with occasional walking or standing. A minimum of physical effort with intermittent standing, kneeling, bending, walking, and driving. May require lifting up to twenty (20) pounds on occasion.

ADDITIONAL INFORMATION: This job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Any overtime hours offered in this position are not guaranteed, are an estimate, and are subject to change.

All positions within Hamilton County Government are considered work in-person and require regular and punctual attendance. All positions within Hamilton County Government may require work on Holidays or weekends. Additionally, irregular hours and shift work may be required, including possible extension of shift hours, at times with short notice.

AN EQUAL OPPORTUNITY EMPLOYER Hamilton County does not discriminate on the basis of race, color, national origin, sex, religion, age, or disability in employment or the provision of services. A copy of Hamilton County's Equal Employment Opportunity Plan (EEOP) & Utilization Report is available on the County's Equal Employment Opportunity (EEO) Office home page. https://www.hamiltontn.gov/Department_EqualEmploymentOpportunityOffice.aspx