Senior Risk/Claims Specialist

Job Location: This position will be located at the Harry S Truman State Office building, 301 W. High St., Jefferson City, MO

Why you’ll love this position:

This is an advanced professional position responsible from inception to conclusion for unique, complex, or high monetary claims or evaluation of potential loss exposures and underwriting of claims. The position will independently develop effective strategies to satisfactorily resolve claims.

When accepting a claim, the position will have the autonomy to evaluate the economic value and complete necessary documentation to award benefits up to a predetermined payment authority limit. This position will complete administrative orders setting forth the claim decision based on the most appropriate laws, policy, and procedures. This position may represent an area of knowledge (e.g. loss control) and provide functional expertise; provide advice on the most appropriate course of action; or provide testimony or other support to the legal process.

This position corresponds and communicates with injured workers, state and public entities, medical and legal professionals, insurance providers, and/or others, and provides one-on-one assistance with the processing of workers' compensation claims.

The salary indicated represents a base pay rate. If the individual selected or the position is eligible for a pay differential (e.g., shift, security, or years of service), it will be added to the total compensation in your paycheck. A pay differential does not raise your base pay.

• Maintain knowledge of workers' compensation laws, policies, and procedures.
• Utilize expertise to assist staff on policies and procedures of workers' compensation processes.
• Serve as a resource to adjusting team, state agencies, and attorneys on workers' compensation issues.
• Identify compensability and negotiate settlements for litigated workers' compensation claims.
• Correspond with attorneys and employers.
• Calculate workers' compensation benefits.
• Review medical files and documents.
• Ensure authorized treatment in relation to an injury and approve medical bills.

Minimum Qualifications

• One or more years of experience as a Senior Risk/Claims Technician (formerly Risk Management Technician II or III). OR, a Bachelor's degree from an accredited college or university and, two or more years of professional experience in areas of risk management, workers' compensation, property and liability, risk and loss control, underwriting, or in the administration of commercial insurance.
  
  

Preferred Knowledge, Skills, and Abilities

• Knowledge of claims handling, workers’ compensation, insurance liability, and underwriting practices.
• Skill in providing customer service, communication, and interpersonal interaction.
• Ability to think critically, interpret and explain rules, regulations, and policies.
• Ability to perform mathematical calculations, interpret data, maintain accuracy, and work independently.
• Knowledge of policies, procedures, and statutes relating to the workers' compensation program.
• Ability to maintain effective working relationships and interact professionally with staff, claimants, state agencies, medical providers, and attorneys.

Lack of post-secondary education will not be used as the sole basis denying consideration to any applicant.

Successful background check results are required for employment in this position. This may include background checks involving a candidate's name and/or fingerprints and other screenings as needed for the specific position

The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here .

recruiter@oa.mo.gov

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• State of Missouri

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