Senior Claims Representative - Workers' Compensation / Automobile

About RTS RTS is a transit authority established by New York State with more than 1,000 employees who proudly serve customers and business partners in Monroe, Genesee, Livingston, Ontario, Seneca, Wayne, and Wyoming counties. Recognized as one of the best-run transit systems in the nation, RTS connects the community by providing public transportation services to more than 10 million people each year.

We carry out our mission by connecting our customers to jobs, school, healthcare, shopping, and recreational activities every day. JOB SUMMARY: Join our growing team of dedicated public transit professionals at RTS with your expertise in the administration of self-insured property/casualty claims.

This opportunity is a primarily a desk position consisting of handling Workers' Compensation and Automobile Liability claims on behalf of the Transportation Authority's Legal Affairs Department. The position is responsible for the investigation, evaluation, disposition, and settlement of the most complex claims and highest exposures with minimal supervision. This includes the investigation, determination, and evaluation of coverage, liability and damages, and the setting of sufficient reserves.

SALARY: $58,000-$68,000 annually (depending on experience) BENEFITS INCLUDE: Staying Healthy: Medical, Dental, and Vision (Dental & Vision insurance are currently free), Flexible Spending Account (FSA) Feeling Secure:

Disability Insurance, Pension Plan, NY State Deferred Compensation Plan, Basic Life and Accidental Death & Dismemberment (AD&D) insurance, Group Specified Disease Insurance and Hospital Insurance Work-Life Balance: Paid Time Off (PTO: 17 days upon hire; accrue additional time after 1 year), Employee Assistance Program, Paid Holidays, Verizon Wireless Discount, On-site Fitness Center open 24/7, Employee Wellness Program, Culture & Inclusion Council, Public Service Loan Forgiveness (PSLF), BJ's Wholesale Club Discount, and more! Click here to view current medical plan rates!

ESSENTIAL FUNCTIONS: Analyzes and processes all levels of workers' compensation and automobile liability claims by investigating and gathering information to determine coverage or compensability and exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Work in partnership with internal managers to deliver innovative solutions and enhance the claims management process.

Think critically, solve problems, plan, and prioritize tasks to optimally serve internal clients and claimants. Negotiates settlement of claims within designated authority. Calculates and assigns appropriate reserves on a timely basis; manages reserve adequacy throughout life of each claim.

Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost-effective claims resolution.

Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. Manages claim recoveries, including but not limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

Reports claims to the excess carrier, as may be required; responds to requests of directions in a professional and timely manner. Communicates claim activity and processing with the claimant and employer; maintains professional claimant and client relationships. Ensures claim files are properly documented and claims coding is correct.

Ensures compliance to state and federal reporting requirements including Section 111 reporting. Regularly generates total experience reporting to internal Departments as business needs require. Other duties as assigned.

EDUCATION & EXPERIENCE: High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.

Minimum of five (5) years related Workers' Compensation and Automobile Liability claims experience. New York State Casualty Adjuster License preferred. KNOWLEDGE, SKILLS & ABILITIES:

Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Excellent oral and written communication, including presentation skills. PC literate, including Microsoft Office products.

Analytical and interpretive skills. Strong organizational skills and ability to meet time sensitive deadlines. Good interpersonal skills.

Excellent negotiation skills. Ability to work independently and in a team environment. Ability to meet or exceed Industry Best Standards.

PHYSICAL DEMANDS & WORK ENVIRONMENT: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit while using hands to finger, handle, or feel objects, tools, or controls. The employee frequently is required to stand, walk, talk, hear, see, and use a computer. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

May occasionally be required to travel to perform field investigations. The employee must occasionally lift and/or move up to 20 pounds. The noise level in the work environment is usually moderate.

This position is eligible to participate in a hybrid work model. Hybrid work is a flexible working model where employees work partly in the office and partly remote from an approved location. All employees must adhere to the Company Telecommuting Policy & Agreement if they choose to participate in the hybrid work model. (Approval to participate is at the discretion of the employer after training period is complete.) ADDITIONAL INFORMATION:

Rochester Genesee Regional Transportation Authority (RGRTA) is committed to equal opportunity for all, without regard to race, religion, color, national origin, citizenship, sex, sexual orientation, gender identity, age, veteran status, disability, genetic information, or any other protected characteristic. RGRTA will make reasonable accommodations for known physical or mental limitations of otherwise qualified employees and applicants with disabilities unless the accommodation would impose an undue hardship on the operation of our business.