Jobs in this family manage, investigate, evaluate, and negotiate resolutions to claims for and against the State involving the areas of worker's compensation claims, tort claims, property and casualty, safety and loss prevention, medical cost containment, and consumer services.

Jobs and Descriptions

Risk/Claims Specialist I

First-level Risks/Claims professional position accountable for assisting parties involved in the settlement of routine insurance and/or workers’ compensation claims. Employees are responsible for processing and analyzing forms, reports, and other documents which are submitted in connection with workers' compensation claims and analyzing insurance claim reports and comparing them with insurance contracts. Responsibilities may include reviewing insurance policies and explaining coverages to consumers, and providing information to public on status of claims, applicable file numbers, and filing dates. Works under the general supervision of a supervisor/manager.

Typically requires a Bachelor’s degree and 0-2 years of experience.

OCCU: 9084
Pay Grade: MS08

Risk/Claims Specialist II

Second-level Risks/Claims professional position accountable for assisting consumers and employers in processing of workers’ compensation cases and/or consumers having difficulty in obtaining settlement of routine insurance claims. Accountabilities may include interpreting law and assisting in settlements between employees, employers, and insurance carriers; corresponding and communicating with injured workers, state and public entities, medical and legal professionals, insurance providers, and/or others, providing one-on-one assistance with the reporting and processing of claims; and contacting insurance companies to obtain clarification and settlement of allowable claims. At this level, employees exercise a higher degree of decision making and independence.

Typically requires a Bachelor’s degree and 2-4 years of experience.

OCCU: 9085
Pay Grade: MS11

Risk/Claims Specialist Team Lead

First-level Risks/Claims supervisory position accountable for managing the activities of risk/claims professionals responsible for performing more complex functions in an assigned specialty area (safety and loss prevention, worker's compensation claims, and consumer services) and assisting with underwriting and evaluating potential loss exposures which represent the legal interests and obligations of the State. Employees are responsible for overseeing the review of rating factors to determine appropriate rate classifications and the collection and formulation of technical underwriting data. At this level, employee supervision includes hire recommendations; training; work planning, assignments, and review; and performance assessment, coaching, and progressive discipline. Supervision at this level also requires employees to possess the knowledge and skills to perform and review the work overseen.

Typically requires a Bachelor’s degree and 5+ years of experience.

OCCU: 9086
Pay Grade: MS13

Risk/Claims Specialist Supervisor

Second-level Risks/Claims supervisory position responsible for planning and directing specific risks and claims programs. Employees represent an assigned area of knowledge (safety and loss prevention, worker's compensation claims, consumer services, risk management, tort claims, self-insurance, property and casualty, and medical cost containment) and provide functional expertise related to policies, procedures, rules, and regulations. At this level, employee supervision includes hire recommendations; training; work planning, assignments, and review; and performance assessment, coaching, and progressive discipline. Supervision at this level also requires employees to possess the knowledge and skills to perform and review the work overseen.

Typically requires a Bachelor’s degree and 7+ years of experience and 2-3 years of supervisory experience.

OCCU: 9087
Pay Grade: MS14

Risk/Claims Specialist Manager

Seasoned Risks/Claims supervisory position responsible for the administration of statewide risks and claims programs, including supervising staff directly managing these programs. The work is highly complex and specialized with a leadership performance level of risks/claims administration in an assigned specialty area (safety and loss prevention, worker's compensation claims, consumer services, risk management, tort claims, self-insurance, property and casualty, and medical cost containment). Employees are responsible for performing specialized work that involves highly complex risks and claims work in an assigned specialty programmatic area, analyze administrative problems and provide risks and claims functional expertise in determining needed regulations, policies, and procedures for proper administration of programs. At this level, employee supervision includes hire recommendations; training; work planning, assignments, and review; and performance assessment, coaching, and progressive discipline. Supervision at this level also requires employees to possess the knowledge and skills to perform and review the work overseen.

Typically requires a Bachelor’s degree and 10+ years of experience and 4-6 years of supervisory experience.

OCCU: 9088
Pay Grade: MS15