MINIMUM QUALIFICATIONS

Education

• Bachelors’ degree in Business Administration, Risk Management, or a related field
  • In lieu of a Bachelor’s degree, a high school diploma or General Equivalency Diploma (GED) with four (4) years or insurance industry experience

Experience

• A minimum of ten (10) years of experience as an insurance claims adjuster, claims examiner, or claims supervisor, one of which was in a leadership position.
• Must have a thorough understanding of insurance-related legal procedures, regulations, and claims processing.
• Strong proficiency in Microsoft Office computer programs including Excel, Word, and other programs is necessary.

Certification/Licensure

• N/A

Preferred

• Master’s degree in Business Administration or a related field
• Preferred 5-7 years handling litigated and complex casualty Claims

MEDICAL GROUP

Satisfactorily complete the medical examination for this position, if required. The incumbent must be able to perform the essential functions of this position either with or without reasonable accommodations.

SUMMARY

The Claims Adjuster, Litigation Specialist is responsible for ensuring quality and cost-effective litigation management through evaluation and oversight over legal counsel. The Claims Adjuster, Litigation Specialist is responsible for assisting the Claims Manager with the management, preparation, formulation, review, and execution of the Authority’s Third-Party Liability Unit (TPL) high profile and litigated claims. The Claims Adjuster, Litigation Specialist is required to investigate, evaluate, mitigate, and resolve litigated and high exposure casualty claims involving protracted and complex litigation while operating with tact and discretion.

ESSENTIAL FUNCTIONS

• Works closely with in house counsel to investigate, evaluate, reserve, negotiate and resolve WMATA’s most severe and/or complex claims, in multiple jurisdictions, in accordance with Best Practices.
• Provides quality claim handling and superior customer service on assigned claims, while engaging in indemnity and expense management.
• Promptly manages claims by completing essential functions including contacts, investigation, damages development, evaluation, reserving, litigation management, negotiating and resolution.
• Directly investigates each claim through prompt and strategic contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers, and technical experts to determine the extent of liability, damages, and contribution potential.
• Interviews witnesses and stakeholders; takes necessary statements, as strategically appropriate.
• Completes outside investigation as needed per case specifics.
• Utilizes diary management system to ensure that all claims are handled timely.
• At required time intervals, evaluates liability & damages exposure.
• Establishes and maintains proper indemnity & expense reserves.
• Applies the Company's claim quality management protocols, best practices, and metrics to all claims; documents the rationale for any departure from applicable protocols and metrics.
• Recommends appropriate cases for discussion at roundtable.
• Updates appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
• Represents the company as a technical resource, attends legal proceedings as needed, acts within established professional guidelines as well as applicable state laws.
• Obtains and evaluates current information regarding trends in the law; digests and communicates this information to the Third-Party Liability Team.
• Assists in the recognition of available defenses to contain loss payout and setting of appropriate reserves.
• Regularly and actively participates in field severity roundtables to share expertise and recommendations in all aspects of severe claim management.
• Develops litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy our customers.
• Tracks and controls legal expenses to assure cost-effective resolution.
• Attends depositions, mediations, arbitrations, pre-trials, trials, and all other legal proceedings, as needed.
• Appropriately deals with information that is considered personal and confidential

OTHER FUNCTIONS

The functions listed are not intended to limit specific duties and responsibilities of any particular position. Nor is it intended to limit in any way the right of managers and supervisors to assign, direct and control the work of employees under their supervision.

Closing
WMATA is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable federal law.
This posting is an announcement of a vacant position under recruitment. It is not intended to replace the official job description. Job descriptions are available upon confirmation of an interview.