Class Code: AS108
FLSA Status: Non-exempt

Claims Technician II

Bargaining Unit: SEA

DEFINITION:

Under general supervision, a Claims Technician II performs technical duties to support Santa Cruz METRO risk management functions and activities; receives, reviews and processes injury and property damage claims to assist Santa Cruz METRO Counsel with the determination of Santa Cruz METRO liability; uses established procedures to conduct field investigations of  accidents/incidents claims and litigation filed against Santa Cruz METRO; administers settlements for routine liability claims based on established parameters; administers property recovery activities; and performs related work as required.

DISTINGUISHING CHARACTERISTICS:

Claims Technician II is the journey-level class of the series.  An incumbent in this class performs the full scope of journey-level technical office and field tasks requiring interpretation and application of department policies and procedures and specialized investigative skills.  This class may be distinguished from the lower level class of Claims Technician I because an incumbent in the latter class performs a limited range of technical claims duties while learning to perform the full range of journey-level work.  

EXAMPLES OF DUTIES AND RESPONSIBILITIES:

The duties listed below represent the various types of work that may be performed. The omission of specific statements of duties does not exclude them if the work is related or a logical assignment to this class.

  • Performs journey-level technical duties to support Santa Cruz METRO risk management functions and activities.
  • Receives, reviews and processes injury and property damage claims to assist in the determination of Santa Cruz METRO liability; collects and records accident/incident information; organizes materials and establishes/maintains claim files; verifies medical treatment expenses and lost wages; compiles data on the value of property damage. 
  • Maintains and tracks the status of claims and prepares regular status reports.
  • Conducts field investigations of accidents/incidents using established procedures; interviews and takes statements of claimants, employees, and witnesses; visits accident scenes and takes pictures and measurements; examines and documents property damage; gathers injury and other pertinent information; observes and documents hazards found during investigations.
  • Assists in preparing discovery documents and performing investigation tasks related to litigation files; assists at trials, hearings, and other legal proceedings as required. 
  • Administers recovery actions for property damages sustained by Santa Cruz METRO from vehicle accidents, tenant lease agreements and other related expenses. 
  • Administers routine settlements or other actions on litigated and non-litigated claims within established limits; may participate in negotiations. 
  • May represent Santa Cruz METRO as a witness in small claims court hearings; prepares and provides appropriate information and required documentation. 
  • Operates field investigation tools including photographic equipment; operates Santa Cruz METRO vehicles, computer programs and equipment, and other office machines. 
  • Performs other technical duties in support of departmental administrative functions; researches issues and prepares summaries of findings; initiates, composes and/or prepares memos, letters, reports, statistical data, and narrative documents; develops, prepares, distributes, maintains and files a variety of reports, records, and documentation; maintains logs, spreadsheets, lists and files to track processes and information.
  • Provides information to employees and the public. 
  • Operates standard office equipment; utilizes computer software in performing job tasks; operates field investigation tools including photographic equipment.
  • Utilizes standard business software in performing job tasks; 
  • May utilize specialized Santa Cruz METRO software.  
  • Drive a Santa Cruz METRO vehicle to perform assignments.
  • Performs related work as required

EMPLOYMENT STANDARDS:

Knowledge of:

  • Basic laws relating to property and liability claims, including contributory negligence theories.
  • Basic California judicial system procedures related to liability claims.
  • Basic medical and legal terminology and related documents.
  • Claims investigation methods and techniques, including methods of negotiating settlements. 
  • Interviewing principles and techniques.
  • Field procedures and techniques for collecting evidence at accident/incident sites.
  • Safety regulations pertaining to hazardous materials at an accident/incident site. 
  • Basic discovery techniques.
  • Modern office practices, procedures, and equipment.
  • Business correspondence, formatting and report writing.       
  • Manual and automated record-keeping and filing systems.
  • Methods of maintaining information in digital or hard copy files.
  • Technical methods of researching, gathering, organizing and reporting data.
  • Methods of prioritizing, planning and organizing work.
  • Time management techniques.
  • Customer service techniques.
  • Intermediate mathematics, including ratios, percentages, and intermediate statistics.
  • The effective use of modern office equipment, personal computers, and standard business software. 

Ability to:

  • Understand and apply laws and administrative policies and procedures in the evaluation of routine property and liability insurance claims.
  • Investigate and recommend settlement of routine property and liability claims.
  • Investigate accident scenes, analyze events and draw sound conclusions.
  • Interview witnesses on the telephone and in person. 
  • Prepare files, documents, charts, reports, and correspondence.
  • Adhere to established work schedules and timelines.
  • Work independently using good judgment, tact, and discretion.
  • Balance multiple assignments simultaneously and effectively.
  • Utilize standard office equipment and computer software and learn to use specialized Santa Cruz METRO software if assigned.
  • Maintain confidentiality of materials, records, files, and other privileged information.
  • Communicate clearly and effectively in both oral and written form.
  • Establish and maintain effective working relationships within the department and with other divisions, departments, agencies, suppliers, vendors, and the public. 

MINIMUM QUALIFICATIONS:

Any combination of experience and education that would likely provide the required knowledge and abilities is qualifying.  A typical way to obtain the knowledge and abilities would be: 

Education, Training, and Experience:

Two (2) years course work from an accredited college in paralegal studies, risk management, claims resolution, business law, law enforcement, business administration, or a related field of coursework.

AND

Two (2) years of experience performing property and liability claims investigation.

LICENSES AND CERTIFICATES:

A valid California Driver’s License will be required at the time of appointment and throughout employment.

Must be able to obtain and maintain a current, valid California Class “C” Driver’s License.

SPECIAL REQUIREMENTS:

  • Must be fluent in both English and Spanish.

PHYSICAL AND MENTAL DEMANDS:

The physical and mental demands described here are representative of those that must be met by employees to successfully perform the essential functions of this class.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Physical Demands 

While performing the duties of this job, the employee is frequently required to reach with hands and arms; walk, sit and stand; use finger dexterity; talk and hear, and use a keyboard. Work often requires stooping at the waist and the repetitive use of both hands to grasp and feel objects. Work may require lifting up to 20 pounds unaided.   Specific visual abilities required for this job include close vision, distance vision, the ability to see colors and shades, and the ability to perceive depth. 

Mental Demands 

While performing the duties of this job, an employee uses written and oral communication skills; reads and interprets data, information and documents; solves problems; uses math and mathematical reasoning; performs detailed work; deals with multiple concurrent tasks; and interacts with others encountered in the course of work.

Work Environment: 

The employee frequently works in a standard office environment where the noise level is usually moderate.  Fieldwork is occasionally required.   

OTHER CONDITIONS OF EMPLOYMENT:

  • Must pass a requisite background check.
  • May occasionally work extended hours or hours outside of the regular schedule.

*Adopted: 12-11-18

*BOD Approved: 08-23-19

*Revised: 00-00-00

*Job Family: Administrative Technical

*Job Series: Claims Technician

*Job Series Level: Journey

*Confidential: No