Sr Claims Adjuster (Liability)
Houston, TX, US
Basic Function
Responsible for investigating and administering assigned Liability claims and when warranted pursue litigation and subrogation against third parties. Performs duties in a safe, efficient manner and in compliance with all applicable rules and safety procedures.
Responsibilities and Specific Duties
- Investigates and administers liability claims of varying complexity including, bodily injury, first party auto, third party auto, first party property, and general liability.
- Sets appropriate financial reserves and maintains adequate funding.
- Sets appropriate diary date schedule according to claim milestones.
- Takes recorded statements from involved parties and explains the Texas Tort Claims Act and procedures as needed.
- Requests indexing of all injured parties through Insurance Services Office (ISO) and confirms eligibility for benefits through Centers for Medicaid & Medicare Services (CMS).
- Requests damage appraisals, police reports, medical bills, medical reports and wage information.
- Reviews facts, establishes liability, evaluates damages and negotiates appropriate settlements within the authority granted based upon all known facts.
- Reports suspected fraudulent claim activities to the appropriate law enforcement agency, NICB or counsel for METRO.
- Maintains contact with all parties regarding claims (i.e., repair vendors, appraisal vendors, doctors, claimants, and attorneys).
- Coordinates investigation with Workers’ Compensation adjusters to avoid duplication of processes and subrogation pursuit.
- May be required to represent METRO at mediations, depositions, pretrial hearings and other legal proceedings as deemed appropriate.
- Provides any additional information requested by supervisors or lawyers relating to claims.
- Reviews claim files on a daily diary basis and pursues subrogation and salvage recoveries.
- Provides excellent customer service to METRO internal and external customers.
- Applies SMS methods and principles in their daily routine and supports all aspects of the agency’s Public Transportation Agency Safety Plan (PTASP).
- Promotes safety awareness and follows safety procedures to reduce or eliminate accidents.
- Performs other job-related duties as assigned.
Education Requirement
High school diploma or GED is required. Bachelor’s degree in Risk Management, Finance or Business Administration preferred.
Years & Experience Required
Minimum five (5) years of progressively responsible liability claims and litigation experience. Bilingual preferred.
Knowledge & Skills Required
Excellent analytical skills in researching and reviewing negligence accident reports, statements or interrogatories, medical bills, indexes and medical narratives. Good communications (written and verbal) skills. Must have an understanding of legal insurance and medical terminology and functional knowledge of Texas Tort Claims Act and/or Texas Workers’ Compensation Act. Texas Insurance Adjusters license in one of these types: Texas Property and Casualty or a Texas All Lines license is required.
Additional Information
The Metropolitan Transit Authority of Harris County, Texas has a zero-tolerance drug and alcohol policy for all employees. All internal and external applicants will be required to undergo drug testing before employment and will be subject to further drug and/or alcohol testing throughout their employment.
Further, employees who perform safety-sensitive functions will submit to drug and/or alcohol testing in accordance to the Department of Transportation (DOT) and the Federal Transit Administration (FTA) regulatory requirements.
We provide equal opportunity to all qualified individuals regardless of race, color, religion, age, sex, national origin, veteran status, genetic information or disability.
Nearest Major Market: Houston