03/01/1983 04450

UNDERWRITING AND CLAIMS COORDINATOR, DGS

DEFINITION: This is responsible technical and administrative work in carrying out the underwriting review, claims processing, disbursement and recovery associated with various coverages in the Commonwealth's insurance/self-insurance programs.

The employee in this class is responsible for the administration, planning and implementation of a program to protect the Commonwealth against catastrophic loss. Work involves arranging for and interpretation of coverage and the processing of claims on behalf of Commonwealth agencies for the Commonwealth self-insurance programs and/or commercial insurance policies. Employee serves as the representative for the Commonwealth's Risk and Insurance Manager as designated to attend meetings and conferences. Employee participates in and supervises an administrative and clerical staff involved in development and maintenance of a computerized claims logging and status system; recovery and/or adjustments of claims where remuneration is due the Commonwealth; categorization of claims, assuring assignment to appropriate area of responsibility; closeout of claims after resolution; correspondence regarding claims and complaints; and assuring appropriate underwriting and procedures by commercial carriers bidding on provision of insurance and bonding coverage for the Commonwealth. Work also includes research and analysis of various types of risk treatment techniques, and review and development of operational procedures and program regulations. Work is performed independently under the general direction of an administrative superior within legislative and policy guidelines, and is reviewed for program effectiveness.

EXAMPLES OF WORK: Coordinates the Commonwealth Employee Liability Self-Insurance Program (ELSIP) and the Automotive Liability Self- Insurance Program (ALSIP).

Responds to inquiries from claimants and attorneys in reference to the ELSIP and ALSIP programs.

Receives all insurance claims involving Commonwealth agencies and directs the processing on behalf of the agencies.

Initiates recovery procedures where claims involve remuneration to the Commonwealth, including working with the legal staff to arrive at compromise settlements.

Directs the preparation of all claim settlement correspondence.

Develops and maintains computer program capability for identification, status and processing of claims and analysis of the Commonwealth loss experience.

Coordinates computerized insurance analysis to include establishing replacement costs for Commonwealth-owned buildings.

Conducts research projects and studies on various insurance policies and risk treatment techniques to assure that the Commonwealth's insurance program is current.

Reviews, modifies and develops guidelines on insurance-related requests concerning budget, effects of strikes, disasters, and the like.

Provides assistance to other bureau personnel in their area of responsibility by providing loss information and assisting in safety and loss prevention reviews, handling inquiries on tort claims, and the like.

Reviews and audits premium charges and returns premium checks to verify computation of rates and refunds.

Performs related work as required.

REQUIRED KNOWLEDGES, SKILLS, AND ABILIITES: Knowledge of the principles and practices of the insurance industry.

Knowledge of the principles and practices of risk management.

Knowledge of laws and regulations applicable to all aspects of insurance.

Knowledge of insurance claims processing.

Knowledge of Electronic Data Processing capabilities in increasing productivity.

Skill in negotiating claim payment settlements.

Ability to conduct research projects and studies on various insurance policies and risk treatment techniques.

Ability to evaluate and direct the processing of insurance claims.

Ability to interpret and adhere to legal and policy mandates and guidelines.

Ability to evaluate, modify and formulate policies and procedures concerning insurance coverage for Commonwealth agencies.

Ability to analyze insurance policy provisions to determine the existence and extent of liability and to analyze, classify and rate risks.

Ability to establish and maintain effective working relationships with insurance companies and all levels of Commonwealth officials.

Ability to coordinate a Commonwealth-wide program.

Ability to plan and direct a staff of administrative and clerical employees.

Ability to express ideas clearly and effectively, orally and in writing.

MINIMUM EXPERIENCE AND TRAINING: Five years of progressively responsible technical and administrative experience in the insurance industry or risk management field, with specific experience in property and casualty underwriting and claims, including three years in a supervisory capacity; and a bachelor's degree with major course work in business and/or insurance.

or

Any equivalent combination of experience and training.