What are the responsibilities and job description for the Lead Claims Agent position at WSSC Water?
The Lead Claims Agent performs analysis and manages claims files within the unit. Leads, trains, and monitors the activities of liability Claims Adjusters and other Claims staff.
Essential Functions
- Assists with the assignment of loss claims filed against the Commission and the disposition of the same
- Reviews, and evaluates liability claims in accordance with the Commission’s self-insurance program; checks for coverage – ensuring timely investigation, reserves and resolution of claims while maintaining fair and adequate settlement amounts
Acts as a resource for answering claims questions and inquiries
Works with the Section Manager to coordinate staff training and development
Makes recommendations and assists Claims Manager with developing and evaluating claims procedures
Reviews files for reserve and settlement authority
Assists Claims Manager with maintaining performance documentation for agents
Responsible for ensuring that customer requests/inquiries are responded to in a timely and effective manner resulting in high customer satisfaction and in compliance with WSSC Water’s policies, procedures and regulations
Handles escalated customer problems referred by the Claims Manager, Deputy General Counsel, General Counsel, Commissioners and General Manager/CEO
- Coordinates with other teams and field staff to ensure timely and accurate claims processing and handling of customers
Other Functions
- Participates in Claims Dispute Resolving Committee hearings and testifies in court and depositions
- Handles complex claims as required
Performs other related duties as assigned
Work Environment And Physical Demands
Work is performed in a business casual office setting
Required Knowledge, Skills, And Abilities
- Thorough knowledge of claims investigative work and claims related procedures
- Ability to gain thorough knowledge of the Maintenance Management Information System (MMIS) and Claims database
Excellent organizational, analytical and decision-making skills
Knowledge of supervising claims adjustments
Ability to effectively handle difficult customer situations
Excellent organizational, analytical and decision-making skills
Ability to plan, assign and supervise the work of subordinate employees
Ability to communicate effectively in both verbal and written form
Minimum Education, Experience Requirements
- Associate’s degree in Claims, Business Administration or related discipline
- 5 years’ experience investigating, evaluating and resolving complex liability or property claims
OR
- High School diploma or equivalent
- 7 years’ experience investigating, evaluating and resolving complex liability or property claims
Directly reports to the Manager of the Claims Section and is responsible for the analysis and management of claim files within the unit. Leads, trains, and monitors the activities of liability claims adjusters and other Claims staff.
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