Claims Manager

About the role

The Claims Manager oversees the City of El Paso’s insurance programs, including workers’ compensation, property/casualty, and subrogation/recovery claims. Key responsibilities include identifying and mitigating risks, managing complex claims, and negotiating settlements.

Responsibilities

• Identify, assess, and mitigate risks associated with human, physical, and liability claims.
• Administer and coordinate claims processing, including medical/case management, claims strategy, negotiation, and adjudication.
• Monitor and ensure the accuracy of claims financial data maintained in the Risk Management Information System (RMIS).
• Set financial reserves for claims and conduct periodic internal reserve audits.
• Represent the City of El Paso at settlement conferences, hearings, arbitrations, mediations, and trials.
• Manage the return-to-work/transitional duty program for injured workers.
• Manage third-party administrator processes on workers’ compensation claims.
• Provide all tort notices to the City Attorney’s Office upon receipt.
• Establish processes, policy, and priorities, develop and implement procedures on claims processing and maintenance of claims data, program integrity, and controls.
• Conduct periodic claims reviews and management meetings with departments, third-party claims examiners/adjusters, and City Attorney’s Office.
• Advise supervisor on annual claims program budget needs.
• Communicate claims management philosophy, case strategy, and financial implications to management.
• Review and finalize workers’ compensation regulatory reports and ensure compliance with reporting requirements.
• Maintain current knowledge of changes to workers’ compensation, property/casualty, and subrogation/recovery statutes, and act as an in-house resource for departments.
• Provide education and training to employees on claims matters, especially workers’ compensation response and policies/procedures.
• Manage and coordinate recoverable claims to successfully subrogate and facilitate insurance recoveries.
• Assist with Total-Cost-of-Risk analysis, insurance, and self-insured cost forecasting, and data analysis including reviewing and providing input on data trends and variances.
• Serve on special project teams and assignments.
• Supervise assigned staff.

Requirements

• Education and Experience: Bachelor’s Degree or higher in Business or Public Administration, Finance, Risk Management, Insurance, or a related field, and four (4) years of professional experience administering workers’ compensation, property and casualty insurance claims, self-insurance, or captive insurance programs, including two (2) years of lead or supervisory experience.
• Licenses and Certificates: Valid Texas Class "C" Driver's License or equivalent from another state by time of appointment. A Workers’ Compensation Adjustor’s license is required within one (1) year of appointment. Property & Casualty Adjuster License required within one (1) year of appointment. An Associate in Risk Management from the Insurance Institute of America and/or Certified Claims Examiner Certification from the State of Texas is preferred.

Qualifications

• Valid Texas Class "C" Driver's License or equivalent from another state by time of appointment.

Skills

• Strong leadership and supervisory skills.
• Excellent communication and negotiation abilities.
• Knowledge of workers’ compensation, property/casualty, and subrogation/recovery laws and regulations.
• Proficiency in risk management and claims administration.
• Ability to manage multiple tasks and prioritize effectively.

Benefits

• LIFE AND HEALTH INSURANCE: Available at no cost to eligible employees, including basic life insurance, dental, vision, and short-term disability coverage.
• VACATION LEAVE: Eligible for vacation allowance after six months of service, with rates based on hours worked.
• SICK LEAVE WITH PAY: Available for employees to use for personal illness or injury.
• ACCIDENT WITH PAY LEAVE: Available for occupational injuries and occupational diseases.
• PREGNANCY LEAVE: Eligible for leave with pay during pregnancy, with medical documentation required.
• LEGAL HOLIDAYS: Observance of federal and city holidays, including Cesar Chavez Day, Juneteenth, and others.

Pay

Details on pay structure and salary range are available upon request.

Schedule

The schedule for this position is typically full-time, with specific details provided in the job specification.