Senior Claims Analyst - City

$33.80 - $51.62 Hourly

Note:  The normal starting pay for this position is the minimum of the pay range listed above. A higher rate of pay may be considered, dependent on the qualifications and experience of the selected applicant and/or the City’s step placement policy.

Note: This position is an overage. Funding for this position will be re-evaluated on a fiscal year basis.

Important APPLICANT Information: 

• When completing the application, applicants will be asked to respond to application questions.  These application questions are based on the Job Requirements for the position.  
• Completion of the application questions is required. 
• Applicant responses to the application questions must specifically answer the questions asked. 
• Responses to application questions must be supported by work history/information listed on the application/resume, sufficient to demonstrate qualifications for the position.  
• Applications may not be reviewed if specific responses to application questions have not been provided.
• Each application submission is reviewed independently.  

Important BENEFITS Information:

• The City offers competitive pay and robust benefits: https://www.okc.gov/home/showdocument?id=47740&t=638783981410928803

JOB SUMMARY  

This position is located in the Risk Management Division of the Finance Department within the City of Oklahoma City and is under the direction of an immediate supervisor.  The Senior Claims Analyst is responsible for gathering, researching, analyzing, coordinating, and confirming information pertinent to various workers’ compensation claims involving mediation, dismissals with prejudice, subrogation, or other complex legal issues.  The duties performed require the utilization of previously acquired technical knowledge and skills.  Essential job functions include:  administrating key contracts within the organization, such as Medicare Reporting, Private Investigation, Field Nurse Assignment or Off-site storage contracts; assisting in maintaining an effective and economical claims administration system; processing and investigating claims; assisting in the defense and subrogation of claims; and preparing investigation materials on all claims involving monetary or time loss.  Additional duties and responsibilities include: coordinating meetings related to return to work and alternate placement; conducting large-scale training sessions on worker’s compensation rules and reporting for customer departments; preparing written reports of meetings attended; conducting telephone investigations; traveling to various departments to identify and consider the parameters, circumstances and conditions regarding specific injuries; evaluating claims to determine acceptance or denial; preparing for and attending mediations and trials; negotiating settlements; and maintaining accurate logs of information gathered on all claims.  The position is also responsible for tracking claims and preparing payments for accepted claims and assisting the Workers’ Compensation Administrator in developing and evaluating policies, procedures, and programs that impact the work unit.  The Senior Claims Analyst may supervise other Claims Analysts. The incumbent works primarily independently and reports to an immediate supervisor.  The incumbent has frequent contact with claimants, supervisors and management, contractors, medical providers, and regulatory agencies.   The work performed is reviewed by the supervisor for soundness of judgement, decisions made, compliance with policies and procedures, accuracy, timeliness, clarity, and overall accomplishments. 

VETERANS PREFERENCE

Honorably discharged veterans of the United States Active Duty Armed Forces, National Guard, and Reserve Forces who are not currently employed full-time by the City of Oklahoma City and who meet the qualifications for the position shall be given preference. To receive preference, veterans must submit verification of honorable discharge from the United States military service (Department of Defense Form DD214 or NGB Form 22) prior to the closing date of the vacancy announcement. 

JOB REQUIREMENTS 

• Knowledge of the principles, policies and procedures of claims management, billing, and subrogation techniques.
• Knowledge of, and skill in, utilizing basic research principles and practices.
• Skill in organizing and analyzing large amounts of data.
• Skill in exercising independent judgement and in making decisions within established guidelines.
• Skill in determining, evaluating and analyzing the results of accidents and injuries.
• Skill in utilizing time effectively and maintaining control over a varied caseload.
• Skill in written and verbal communication using tact and diplomacy.
• Skill in supervising or coordinating the work of others.
• Skill in administering key contracts.
• Skill in processing claims involving mediation, settlements, dismissals with prejudice, subrogation, and other complex legal issues.
• Ability to coordinate meetings related to return to work and alternate placement.
• Ability to conduct large-scale training sessions on worker’s compensation rules and reporting for customer departments.
• Ability to establish and maintain effective working relationships.
• Ability to read and interpret legal and administrative guidelines as they pertain to workers’ compensation issues and concerns.
• Ability to travel.
• Willingness to work independently and assume responsibility for work performed.
• Possession of a State Adjuster’s License.

COMPETENCIES

• Execution and Results: (1) Sets well-defined and realistic goals and high standards of performance for self or self and others; (2) displays a high level of initiative, effort, and commitment toward performing work; (3) completes assignments in a thorough, accurate, and timely manner, and delivers results; (4) works with minimal supervision, is motivated to achieve, and demonstrates responsible behavior; (5) demonstrates understanding of all aspects of the job and application of accrued knowledge in carrying out duties and responsibilities; technical knowledge; skill in the techniques, equipment, procedures, and work required; (6) recognizes opportunities and takes action for improvement to programs, policies, procedures, practices, and processes; (7) understands and is able to apply the principles, methods, and tools of quality improvement; (8) collects, examines, analyzes, and interprets data from a variety of sources; (9) makes data-driven recommendations/decisions and achieves results; (10) effectively achieves results through others to achieve the Department or City's mission.
• Judgment: (1) Plans, coordinates, and executes business functions efficiently, effectively, and in a fiscally responsible manner; (2) identifies risks and develops and implements measures to avoid, mitigate, or minimize those risks; (3) makes effective, timely, well-informed, objective, and transparent work-related decisions; (4) exhibits emotional maturity and stability, effectively manages conflict, and remains optimistic and calm during stressful situations; (5) uses resources effectively to achieve results aligned with organizational priorities; (6) applies understanding of financial management/budgeting principles to ensure decisions are fiscally sound and responsible and in accordance with policies, procedures, processes, rules, regulations, and laws; (7) makes business decisions that drive positive, fiscally responsible performance; (8) manages ambiguity, business insight, financial acumen, makes decisions using data and insight that achieves the best outcome for the department and City.
• Teamwork/Team Oriented: (1) Recognizes, values, and leverages the ideas, opinions, and perspectives of others; (2) participates willingly and effectively as a team lead or team member; (3) builds consensus; fosters team commitment, spirit, pride, and trust; (4) collaborates with others to accomplish goals and objectives and achieve results; (5) expresses facts, ideas, messages, and information (technical and non-technical) to individuals or groups clearly, concisely, accurately, understandably, with honesty, tact, and diplomacy and in a manner that is appropriate for the intended audience; (6) actively listens, clarifies information as needed.
• Customer Centric: (1) Demonstrates commitment to public service; (2) serves and satisfies internal and external customers in a timely and effective manner; (3) establishes, commits to, and maintains high standards for producing quality work products and being responsive to customers; (4) supports the Department/City's mission; develops and executes strategies with the customer in mind.
• Strategic Thinking: (1) Thinks conceptually, imaginatively, and systematically; (2) envisions the future; (3) defines the vision, direction, and goals; (4) develops a road map for achievement; (5) anticipates change and plans for it; (6) considers long-term value and consequences; (7) influences others to achieve results; (8) understands where the organization is headed; knows the organization's mission and functions, and how its social, political, and technological systems work; (9) aligns business strategies to long-term success of the City; (10) sets the vision, direction and compelling course of action; (11) operates effectively within the systems, programs, policies, procedures, codes, ordinances, rules, and regulations of the organization; (12) knows industry and stays ahead of best practices; (13) understands the political environment, management priorities, staff roles and responsibilities, and grasps external factors impacting the organization; (14) identifies when issues need to be escalated to higher authorities and effectively alerts appropriate officials.
• Leads Through Influence: (1) Persuades others; builds consensus through give and take; (2) gains cooperation from others to obtain information and accomplish goals; (3) works with others towards achieving agreements that may involve exchanging resources or resolving differences; (4) understands the concepts, practices, and techniques used to identify, engage, influence, and monitor relationships with individuals and groups connected to a work effort including those actively involved; (5) leads through influence over the process and its results, and those who have a vested interest in the outcome (positive or negative).
• Commitment to Continuous Improvement: (1) Recognizes opportunities for improvement with regard to programs, policies, procedures, practices, and processes; (2) understands and is able to apply the principles, methods, and tools of quality improvement; (3) collects, examines, analyzes, and interprets data from a variety of sources; (4) makes data-driven recommendations/decisions and achieves results.
• Agility: (1) Values collaboration, communication, and feedback and is flexible and open to new ideas; (2) learns rapidly and transforms learning into action; (3) examines processes and practices to perform work most effectively; (4) demonstrates courage and willingness to take calculated risks; (5) assesses readiness; proposes new approaches, methods, and technologies plans, implements, and evaluates change in a transparent, positive, and thoughtful manner; (6) exhibits emotional maturity and stability, effectively manages conflict, and remains optimistic and calm during stressful situations; (7) rapidly adapts to change and leads others through change, while producing tangible results and identifying new opportunities.
• Talent Development: (1) Provides tools, materials, equipment, and resources; (2) provides performance feedback, coaching, mentoring, encouragement, and support; (3) discusses personal and professional goals; (4) provides formal and informal learning and development opportunities that support achievement of personal and professional goals; (5) attracts and develops talent; (6) manages performance throughout the department or City; (7) sets the leadership tone for area of responsibility.  Note: This competency is not applicable for employees who are not supervisors.

WORKING CONDITIONS 

• Primarily indoors in a climate-controlled environment.
• Occasional local travel to conduct investigations and out-of-town travel to meetings, conferences, or seminars.
• Occasionally required to work beyond normal work hours.

Note:  Typical City employee working hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. However, working hours vary (may require work to begin before 8:00 a.m. and/or end beyond 5:00 p.m., and/or may require work on weekends and holidays), and are subject to change, based on the duties and location of the position and the business needs of the assigned work unit/department.  

PHYSICAL REQUIREMENTS 

• Near vision enough to read a computer monitor and draft communications such as written or machine-generated documents, reports, etc.
• Finger dexterity enough to operate standard office equipment.
• Hearing and speech enough to communicate by telephone or face-to-face.

OTHER DETAILS

Attachments:  Applicants may upload only two attachments.  Applicants may choose to combine documents into one file for upload. 

Pay Method:  City employees are required to receive pay electronically, either via direct deposit or pay card.

Former Employees:  If this position is open to external applicants and you are a former employee, you must be eligible for rehire to participate in any selection process.  If you are unsure of your rehire status, please contact the Human Resources Department at (405) 297-2530.  If your rehire status has been coded “Not Eligible,” “Eligible 3,” or “Conditional,” you will need to request a review of your rehire status through the Human Resources Department’s Employee and Labor Relations Division.

Background Investigation, Drug Testing, Physical Examination:  Upon a conditional offer of employment/acceptance of position, the City of Oklahoma City will conduct a criminal history background check for external applicants. Applicants will be provided contact information for any third-party reporting agencies used to collect background information in connection with conditional offers of employment.   

If the position accepted includes a driver license (commercial or non-commercial) Job Requirement, the City of Oklahoma City will obtain a Motor Vehicle Report for internal and external applicants. 

If the position accepted is safety sensitive and/or a driving position, internal and external applicants will be provided a copy of the City of Oklahoma City's Drug and Alcohol Testing Policy prior to being directed for a drug test. A copy is also available at the link below:  

HRB 25-01 Drug and  Alcohol Testing Procedure.FINAL 030325_AM.pdf

If the position accepted is cyber security sensitive, internal and external applicants will be subject to a Criminal Justice Information Services (CJIS) Interstate Identification Index (III) Fingerprint Background check. Additionally, employees in this job classification must complete Level 4 Security Awareness Training and pass an online certification test.

If the position accepted includes a lift/push/pull/carry Physical Requirement of 25 pounds and greater, internal and external applicants will be directed for a physical examination. 

AN EQUAL OPPORTUNITY EMPLOYER

If you require reasonable accommodation at any time during the hiring process, please notify one of the Human Resources Department Representatives by calling 405-297-2530. The City of Oklahoma City is an equal opportunity employer and values diversity and inclusion. The City of Oklahoma City will not discriminate against any applicant or employee because of race, color, creed, national origin, ethnicity, religion, sex (to include sexual orientation and gender identity and/or expression), age, genetic information, disability or political affiliation.