Claims Officer

Implement and update PVTA's Claims policies and procedures: Maintain and develop professional knowledge of all regulatory requirements and internal procedures; evaluate all department processes/procedures on an ongoing basis and develop/revise policies and procedures related to all operational aspects of claims management and processing. Manage Department Operations: Manage day-to-day activities within the claims department, including claims adjustment and processing, accident investigations, database management, and litigation; Responsible for all administrative tasks involved with Claims Management including but not limited to , new cases, file management (electronic and hard copy) of new and old cases, statutes and regulations, the legal process, internal policies and procedures, related laws; and serve as resource for all claims-related matters. Oversee Accident Investigation Process: Responsible for monitoring of all claims issues; conduct in-depth investigation processes by collecting all relevant information including coordination of investigation process with relevant parties to ensure proper claims handling; review incident/accident reports and ensure proper investigations are conducted according to established procedures; conduct interviews with operators, claimants, witnesses, attorneys and other relevant parties; coordinate claims processing and arrange for appraisals and independent medical examination when appropriate; request and review related medical records as required. Maintain oversight of settlement procedures: Execute efficient claims resolution and liability containment strategies; set up and properly adjust case reserves; contact insurance companies to engage in settlement activities including negotiations and third-party liability (subrogation); identify key claim issues and work to bring these issues to resolution; authorize claims payments, settlement checks, and payment of other related expenses within granted authority. Actively participate in litigation procedures: Assist with litigation-related matters: Work with outside legal counsel as needed; communicate with legal counsel regarding cases and policy matters; assist with case preparation; and review litigation outcomes to help identify opportunities for improved coordination and results. May be asked to participate in depositions, mediation conferences, and court proceedings related to claims. Oversee Claims Database Management and provide related reporting: Manage all exposures including coverage analysis, liability and injury/damage evaluations and subrogation/deductible recovery; oversee transportation suppliers and ensure compliance with PVTA's policies and procedures related to claims; track and analyze monthly loss run data; prepare Loss Run Reports for high exposure claims and internal/external reporting of same; manage and maintain all oversight files. Keep Management Informed: Keep Director of Transit Operations fully informed on Claims activities via monthly update meetings that will include but not limited to discussion of status on large claims and summary reports of Claims inventory and reserves. Assist with the development and tactical/strategic plans and inform management of progress towards related goal attainment; maintain current claims information; compile, create, and distribute reports including but not limited to: • Incident/accident reports identifying all pertinent information (contractor accident information, dates, location, etc.). • Interview reports identifying accident victims, witnesses, drivers, and any other related parties. • Appraisal reports, which clearly identify the accident, insurance company, adjuster, accident site, etc. • Independent Medical Exam (IME Reports), corresponding to related accidents. • Documentation pertaining to meetings with claimants and attorneys. • Documentation identifying settlement options that were recommended, to whom, and result. • Log of contact information pertaining to discussions with insurance companies, including settlements, negotiations and subrogation details. • Log of specific cases and the legal processes utilized. • Loss and expense reports. • Reports of all depositions, mediation conferences and court trials attended, along with the result. • Reports of all monies owed, monies collected, and related documentation. • Reports identifying releases, settlement amounts, expenses related to claims, and proposed vs. resulting settlements; and • Reports identifying specific claims and status. Perform all other related duties as requested.