The purpose of this position is to coordinate, manage and oversee claims operations of the Georgia Interlocal Risk Management Agency (GIRMA). This includes oversight of defense firms and third-party administrators (TPA) providing claims services to GIRMA. The position is also charged with providing coverage opinions and recommendations.
Facilitate communications between TPA, defense counsel and Fund Members and address any problems or concerns communicated by Fund Membership.
Duties include but are not limited to:
Review all new claims for coverage and conflicts.
Prepare and issue notices of reservation of rights.
Direct TPA on assignment of defense counsel.
Review and approve requests for filing of pre-answer motions.
Participate in representing GIRMA with defense counsel on litigated claims. This includes attending depositions, mediations, hearings and trial preparation meetings.
Monitor and audit work product and processes of TPA to promote proper handling of all claims and compliance with service instructions. This includes monitoring of claim reserves and plans of action.
Monitor work product of defense counsel to ensure compliance with GIRMA standards.
Assist TPA and legal counsel in expediting closure of claims.
Monitor performance metrics of TPA and vendor services.
Ensure settlements are in the best interest of the Fund Member and GIRMA.
Ensure settlements are properly executed and according to governing Federal and Georgia statutes. This includes proper consideration of Medicare Set Aside Agreements.
When appropriate, meet directly with claimants to reduce prevalence of attorney involvement.
Assist TPA and defense counsel in settlement negotiations. This may include negotiating directly with claimants on behalf of GIRMA, the TPA, and defense counsel.
Schedule and perform new member orientation with Fund Members.
Provide notice to Management of safety and claims related trends and concerns. This would include monitoring of legislation and court decisions which may impact political and legal environment exposures of GIRMA.
Assist Management in development and implementation of new services and/or procedures.
Qualifications
Bachelor's degree (Masters' or JD preferred) in risk management / insurance or equivalent in a related field;, or any equivalent combination of education, training, and experience which provides the requisite knowledge, skills, and abilities for this job. Must possess and maintain a valid Georgia Driver's License. Local or state government experience preferred.