ASSISTANT MANAGER, CLAIMS
This is responsible professional, technical and lead work in the investigation, negotiation and settlement of public liability, property damage, and bodily injury accidents and claims, as well as the investigation of complaints against NFTA personnel. An employee in this class is responsible for performing these functions within operational procedures that have been established and has the ability to interpret and apply laws and regulations to case scenarios and maintain working relationships with attorneys, physicians, insurance companies, governmental agencies and the public. This position acts in the in the capacity of the Manager, Claims during his/her absence and oversees the daily work activities of the Claims Representatives to ensure an orderly flow of productivity. Assignments are generally broad in scope with frequent opportunity for exercising independent judgment in making claims management decisions subject to final review and approval by the Manager.
The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. It is not necessarily descriptive of any one position in the class. The omission of an essential function does not preclude management from assigning duties not listed herein if such duties are a logical assignment to the position.
• Provides technical assistance to Claims Representatives; assigns, reviews and monitors work and ensures timely and accurate case management.
• Evaluates and adjusts individual case approaches in concert with the Manager.
• Conducts Workers’ Compensation investigations, supervises loss transfer recoveries and investigates fraudulent activities.
• Coordinates undercover investigations with complete discretion.
• Maintains a database to track and analyze claims data.
• Analyzes and prepares claims trending reports and analysis as needed.
• Organizes and reviews the investigation, negotiation and settlement of a variety of claims; reviews accident reports, losses and litigation claims; and provides intradepartmental personnel with technical advice and assistance.
• Investigates liability claims, no-fault claims and other claims involving personal injury or property loss/damage; investigates scene of the accident; takes detailed statements from involved parties; photographs evidence to document investigation files; peruses video evidence; performs other research as necessary.
• Inspects damage to structure, motor vehicles, and heavy equipment; reviews repair estimates; determines value of claim; presents a cost benefit analysis for settling claims.
• Assists in defense preparation with defense attorneys and various NFTA departments in litigation.
• Represents NFTA in claim settlements; negotiates settlement claims up to an authorized limit or makes recommendations for settlement; attends trials and mediations as necessary.
• Interviews claimants witnesses and employees to secure sworn statements necessary to process claims; investigates accident scenes; reviews medical and employment records of claimants; obtains damage estimates.
• Negotiates with individuals, insurance companies and attorneys to affect an equitable settlement.
• Confers with appropriate doctors, lawyers, judges and insurance carriers.
• Reviews and processes No-Fault claims; evaluates claims for payment, denial or further verification requests in light of regulations; reviews bills; records payments.
KNOWLEDGE, SKILLS and ABILITIES:
Detailed knowledge and experience with NFTA/Metro Claims Department procedures and techniques. Thorough understanding of NFTA/Metro operations. Knowledge of state insurance rules and regulations. Knowledge of medical and legal terminology. Knowledge of reference materials in the field of casualty and loss. Knowledge of regulations and laws relating to no-fault and negligence. Knowledge of claims investigation methods and techniques. Skilled in research techniques. Ability to communicate effectively, orally and in writing, with employees, upset and/or irate individuals, defense and claimant counsel, doctors, judges and insurance carriers. Ability to establish and maintain effective working relationships with employees, the public, attorneys, and professional and private organizations. Ability to determine value of a claim and negotiate equitable settlements. Ability to prepare written reports. Ability to process claims and to respond to inquiries in a timely manner. Ability to read and understand estimates and medical reports and records. Ability to effectively supervise the work of subordinate staff and outside investigators.
Tasks involve the ability to exert light physical effort in sedentary to light work, but which may involve some lifting, carrying, pushing and/or pulling of objects and materials of light weight (5-10 pounds).
Work is performed in both usual office conditions and in the field with exposure to extreme weather conditions. May also be exposed to distraught individuals who disagree with the Authority’s position and will visit all types of urban areas.
A Bachelor’s degree and seven (7) years professional experience adjusting compensation claims, some lead/supervisory experience, with three (3) years experience as and NFTA/Metro Claims Representative, or an equivalent combination of related education, training and experience. A valid New York State driver’s license and a Notary license are required.
Send NFTA employment application, resume and cover letter specifying the job number 040-21-N to:
NFTA Human Resources
181 Ellicott Street
Buffalo, NY 14203
Or email to: email@example.com
The Niagara Frontier Transportation Authority is an Equal Opportunity Employer