Montana Municipal Insurance Authority

MONTANA MUNICIPAL INSURANCE AUTHORITY

POSITION DESCRIPTION

CLAIMS MANAGER - Draft

Updated: 5/1/08

General Purpose:

The Claims Manager directs the overall administration of MMIA’s Liability, Property, and Workers Compensation claims processing functions including department budgeting, personnel supervision, claims policy and procedure development, fiscal responsibility, and coordinates legal functions with MMIA general counsel. Position ensures claims are processed in accordance with MMIA’s claims guidelines and in accordance with generally accepted claims industry principals and practices. The employee performs a variety of routine and complex technical, clerical, and administrative duties to coordinate and administer the organization’s claims functions. Position directly supervises claims staff.

Supervision Received:

Works under the general supervision of the MMIA CEO; is granted a high degree of independent decision making authority within scope of expertise.

Duties and Responsibilities:

·  Provide leadership and direction to claims staff to provide high quality claims processing services consistent with MMIA guidelines and procedures.

·  Provide technical support, direction and advice to claims staff.

·  Work with claims staff to develop initial action plans and monitor claims handling throughout the life of claims.

·  Audit claims files in accordance with claims guidelines.

·  Conduct performance reviews of claims staff consistent with MMIA guidelines and procedures.

·  Establish and monitor claim reserve reports to ensure reserving practices are consistent with MMIA guidelines.

·  Provides claims data and reports to MMIA Risk Management staff, re-insurers, auditors, actuaries, Board of Directors and others as requested.

·  Ensures high quality member service in all aspects of claims processing.

·  Participate as a member of the MMIA management team.

·  Manages and directs claim staff for MMIA for the purpose of ensuring quality claim handling and service to members within guidelines, procedures and budget.

·  Researches a wide variety of programs for the purpose of reviewing and recommending new claims processing policies, procedures and coverage.

·  Coordinates with MMIA Legal Council to review litigated files and assist in claim processing strategy for the purpose of setting appropriate claims reserves and for reinsurance reporting.

·  Establish staff development goals and then monitor and provide technical expertise to staff to assure proper adherence to MMIA standards and procedures.

·  Oversee claims audits process to ensure identified areas of concern are addressed promptly.

·  Significant travel and meetings with MMIA members may be required to manage claims and when providing risk management education.

·  Attends claims mediations with adjusters and attends and monitors claims trials.

Peripheral Duties

Serve as a member of various (statewide) boards and committees as directed by the CEO and attending mediation and trials.

Desired Minimum Qualifications

Education and Experience:

·  A bachelor’s degree from an accredited four-year college or university with a degree in risk management or public administration, or a closely related field.

·  Four (4) years progressive management and/or legal experience.

·  In depth working knowledge of legal principals related to property/casualty claim handling procedures.

Necessary Knowledge, Skills, and Abilities:

·  A working knowledge of generally accepted claims industry principals and practice

·  The ability to prepare high quality written and verbal material and to arrange and present this material in a manner usable to the MMIA Board, management, and member communities.

·  The ability to prepare accurate and reliable reports containing findings, conclusions and recommendations.

·  The ability to establish and maintain effective working relationships with member communities.

·  The ability to make well informed decisions in a timely manner.

·  The ability to work for extended periods of time away from the office with limited supervision.

·  Possess a working knowledge of computer programs (i.e. Windows, Microsoft Word, Excel and Access, PowerPoint etc.).

·  Public speaking and training abilities

·  Possess a valid Montana Drivers License and reliable transportation.

Tool and Equipment Used

This position requires use of an automobile, personal computer, typewriter, telephone, audio visual aids (including PowerPoint, laptop computer, overhead projector, VCR, slide projector, etc.), and copy and fax machines.

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 this 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 walk, climb stairs, stand, sit, talk or hear. The employee is occasionally required to use hands to finger, handle, or feel objects, tools, or controls; and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch or crawl. The employee must occasionally lift and/or move up to 25 pounds. The specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus. The employee is frequently required to drive an automobile, occasionally for long distances.

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.

The employee routinely works in outside weather conditions while inspecting/ surveying/valuating municipal facilities. The employee is occasionally exposed to varying conditions including, cold, heat, humidity and moisture. The employee occasionally works near moving mechanical parts and in high, precarious places and is occasionally exposed to fumes or airborne particles, toxic or caustic chemicals, risk of electrical shock and vibration. The employee travel will frequently involve overnight stays outside of Helena.

The noise level in the work environment is usually quiet to moderate. Work conditions vary with the work site and may occasionally include potential hazardous situations where modifications are not easily and immediately accomplished.

Selection Guidelines

Guidelines include application, rating of education and experience, oral interview and reference checks. Job related tests may also be required.

The duties listed above are intended only as illustrations of various types of work that may be performed. The omissions 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.

The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

Approval: Approval:

Employee Supervisor

Date:

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