Claims Service Representative II

  • Job Code: W1342
  • Pay Grade:WK
  • Pay Scale:$21.75-$35.97 Hourly; $45,240.00-$74,817.60 Annually
  • Exempt:No

Overview

Review and process automobile, general liability, short-term and long-term disability, Family Medical Leave Act (FMLA), and/or Workers' Compensation claims. Must obtain the State of Florida Independent All Lines Adjuster License (6-20) within one year of hire.

Duties & Responsibilities

Note: Depending on assigned responsibilities, employees may perform some or all of the duties below.

  • Review and process automobile, general liability, disability (e.g., short term, long term, FMLA), and/or Workers’ Compensation claims.

  • Follow procedure for wage determination, liability, claimant, and health care provider payments.

  • Follow procedure for getting repair estimates/appraisals of damaged vehicles, subrogating, collecting/paying damages, and closing out the claim upon receipt of all information.

  • Coordinate with the Financial Services Division for payment processing.

  • Coordinate with County Attorney's Office on claims litigation (e.g., restitution).

  • Maintain information on county, state and federal FMLA, auto, and/or Workers’ Compensation rules and regulations.

  • Coordinate automobile, liability, short term and long term disability, FMLA, and/or Workers’ Compensation claims and employee termination processing actions with the applicable parties (e.g., claimants, attorneys, insurance representatives, health care providers, repair shop representatives).

  • Prepare claims and negotiate settlement documentation for the appropriate parties (e.g., health care providers, medical authorizations, rehabilitation counselors, claimants, attorneys, insurance company representatives).

  • Advise agencies and department personnel in the preparation of state forms and payroll reporting.

  • Perform other related duties as required.

Knowledge, Skills & Abilities

  • Working knowledge of automobile, disability, FMLA, and/or Workers’ Compensation claims processing rules and regulations.

  • Working knowledge of automobile claims (internal process).

  • Ability to work effectively with the public and staff.

  • Ability to collect, organize, and evaluate data and to develop logical conclusions.

  • Ability to prioritize work.

  • Ability to handle confidential information.

  • Ability to use a computer and related software.

  • Ability to prepare and maintain work related records and reports.

  • Ability to communicate effectively, both orally and in writing.

Minimum Education & Experience

  • A high school diploma or possession of a GED certificate.

  • Possession of a State of Florida Independent All Lines Adjuster License (6-20) within the probationary period.

  • Three years of experience in liability, disability, FMLA, or Workers' Compensation claims service work.

OR

  • An associate degree from an accredited institution of higher education with a major in insurance, accounting, or finance.

  • Possession of a State of Florida Independent All Lines Adjuster License (6-20) within the probationary period.

  • One year of experience in liability, disability, FMLA, or Workers' Compensation claims service work.

Required Pre-Employment Testing

  • Completion of pre-employment testing.

Additional Job Requirements

  • Attendance at the specified Sheriff's Office work location is required.

  • Depending on assignment, employees may be required to possess a valid Florida Driver License at time of employment. Driving history will be thoroughly reviewed and may be grounds for disqualification.

  • No visible tattoos on face, head, and neck. Tattoos determined to take away from the professional appearance of the Sheriff’s Office must be covered with an appropriate white, black, or neutral covering.

  • No illegal drug sale within lifetime.

  • No illegal drug use within the past 36 months. No marijuana use within the last 12 months.

  • No felony convictions within lifetime.

  • No misdemeanor convictions involving perjury, false statement, or domestic violence within lifetime.

  • No dishonorable discharge from any branch of the United States Armed Forces, the United States Coast Guard, National Guard, or Reserve Forces.

  • Successful completion of a background investigation including criminal, reference, employment, and neighborhood checks; polygraph; medical evaluation; and drug screening.

Last updated: 3/31/2024