Claims Coordinator

Purpose Statement

The job of Claims Coordinator plays a key role in supporting the effective administration of data entry, setup, adjusting and resolution of property and liability claims and other assigned services; and maintaining services within established guidelines and standards. This position exercises sound judgment and professional discretion in ensuring timely setups, accurate communication among internal and external stakeholders. The Claims Coordinator contributes to the overall success of the Claims Department by promoting efficient operations, high-quality service, and adherence to established standards and best practices.

This job reports to Manager of Claims & Legal Affairs or Director of Claims & Litigation. 

Essential Functions

• Serves as a primary liaison between WSRMP and member districts to facilitate communication, teamwork, mutual support, and ensure responsive and professional service in all claim-related matters.
• Administer and resolve assigned property and liability claim files, including subrogation files, by exercising sound judgment and discretion in determining appropriate action, and ensuring quality claim handling and service to member districts in accordance with policies, procedures, and budgets.
• Exercise professional autonomy in prioritizing daily responsibilities, managing assigned caseloads, and ensuring the timely processing within established guidelines.
• Communicate effectively with management, related departments, member district personnel, experts, claimants, attorneys, and other outside organizations for the purpose of coordinating claim activities, responding to inquiries, exchanging information and resolving claim files and lawsuits.
• Review and screen claim forms and incident reports submitted by member districts to determine initial assessment and appropriate coding and staff assignment. Closes claim files upon notification by claims staff.
• Provides administrative, operational, and coordination support to Claims Consultants and departmental leadership to facilitate efficient claims administration, workflow management, and departmental operations.
• Prepare and distribute reports, correspondence, and documentation to ensure transparency and support internal decision-making.
• Monitor claim activity and documentation for accuracy, completeness, and compliance with organizational policies and reinsurance reporting requirements. 
• Exercise initiative and discretion when identifying potential issues, recommending improvements to claims processes, and suggesting efficiencies in workflow or data management.
• Demonstrated willingness and ability to learn new skills, processes, technologies, and insurance industry practices while contributing to a collaborative team environment.
• Maintains and updates claims-related records and databases to ensure data integrity and accessibility.
• Collaborate with other departments to share information and support cohesive member service delivery.
• Supports departmental leadership by assisting with project management, tracking key performance indicators, and contributing to department goals and initiatives. 
• Embodies the principles and practices that form our culture and commitment to Diversity, Equity, Inclusivity, and Belonging for the purpose of meeting WSRMP’s Mission and Targeted Strategies.
• Occasional travel may be required.

Other Functions

• Backup for front desk Administrative Coordinator (Attendance at Fort Dent Office may be required when covering).
• Assists other personnel as may be required for the purpose of ensuring an efficient and effective work environment.
• Assists Finance with posting, reconciling deposits and other financial tasks as needed.
• Performs other related duties as assigned for the purpose of ensuring the efficient and effective functioning of the department.

Job Requirements: Minimum Qualifications

SKILLS are required to perform single, technical tasks with a potential need to upgrade skills to meet changing job conditions. Specific skill-based competencies required to satisfactorily perform the functions of the job include: See competencies under Abilities below.

Basic Skills:

• Ability to use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
• Ability to understand written sentences and paragraphs in work-related documents.
• Ability to give full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. 
• Ability to speak with others to convey information effectively.
• Communicating effectively in writing as appropriate for the needs of the audience.
• Effective time management skills.

Computer Skills:

• Proficiency in the use of Microsoft Office applications (Word, Excel, PowerPoint, Outlook).
• Ability to create and present PowerPoint presentations.
• Ability to manipulate and analyze data in Excel or similar spreadsheet or database software.
• Familiarity with cloud-based collaboration and storage tools such as OneDrive, SharePoint and Confluence.
• Experience with videoconferencing software such as Zoom and Microsoft Teams.
• Basic understanding of computer security and ability to follow company security protocols.

KNOWLEDGE is required to perform basic math, including calculations using fractions, percentages, and/or ratios; understand written procedures, write routine documents, and speak clearly; and solve practical problems. Specific knowledge-based competencies required to satisfactorily perform the functions of the job include: See competencies under Abilities below.                                           

ABILITY is required to schedule activities and/or meetings; gather and/or collate data; and use job-related equipment. Flexibility is required to work with others; work with data utilizing defined and similar processes; and operate equipment using standardized methods. Ability is also required to work with a diversity of individuals; work with similar types of data; and utilize a variety of job-related equipment. Some problem solving may be required to identify issues and select action plans. Problem solving with data may require independent interpretation; and problem solving with equipment is moderate. Specific ability-based competencies required to satisfactorily perform the functions of the job include:

Job-Specific Competencies

ACCURACY AND ATTENTION TO DETAIL: Ensures work is thoughtfully completed, accurate, and error free to the highest degree possible.

PLANNING, ORGANIZATION, AND PRIORITIZATION: Assesses the work to be performed, and considers how it should be organized and accomplished, with appropriate priorities and realistic time parameters.

RECORDKEEPING AND DOCUMENTATION: Gathers, organizes, and maintains records, following confidential information and security protocols as needed. Accurately documents relevant/essential actions, processes, and practices.

TEAMWORK: Works collaboratively with others to achieve shared goals and make decisions.

Responsibility

Responsibilities include working with immediate supervision; providing information and/or advising others; operating within a defined budget. Utilization of some resources from other departments may be required to perform the job's functions. There is some opportunity to impact the organization’s services.

Work Environment

The usual and customary methods of performing the job's functions require the following physical demands: some lifting, carrying, pushing, and/or pulling, some climbing and balancing, some stooping, kneeling, crouching, and/or crawling and significant fine finger dexterity. Generally, the job requires 80% sitting, 10% walking, and 10% standing. The job is performed in a generally hazard free environment and in a clean atmosphere.

Residency:       Washington state

Experience:     Minimum of two (2) years of experience in claims administration, insurance, risk management, administrative support, customer service, or a related field. Experience supporting claims, insurance operations, or risk pooling is preferred.

Education:       High school diploma or equivalent

Equivalency:   None specified

Required Testing

Basic Math Skills

Certificates and Licenses

Valid WA Driver’s License

WSRMP approved driving record

Continuing Education / Training

Regularly attends industry, job-related conferences, and training to upgrade skills to meet changing job conditions                                                                                                                                                           Clearance

Criminal Justice/Background Clearance

FLSA Status: Exempt