Class Code: 00453

IOWA DEPARTMENT OF ADMINISTRATIVE SERVICES –

HUMAN RESOURCES ENTERPRISE

INSURANCE PROGRAM SPECIALIST

DEFINITION

Under general direction, develops and administers a claims and insurance program; or performs specialized administrative work in the coordination and direction of activities associated with the Iowa Worker's Compensation system; performs related work as required.

The Work Examples and Competencies listed are for illustrative purposes only and not intended to be the primary basis for position classification decisions.

WORK EXAMPLES

Assists supervisor by instructing employees, answering questions and distributing, balancing and checking work; may make suggestions on appointments, promotions, performance and reassignments.

Investigates tort claims by reviewing written reports, contacting agency personnel involved or those most knowledgeable of the facts, or contacting outside authorities or experts. Interviews claimants and/or witnesses; assembles all the information and prepares a report of investigation for the Tort Claims Division of the Attorney General's Office.

Conducts investigations of vehicle accidents involving agency owned vehicles; processes accident reports and obtains recoveries or repair settlements; initiates claims for vehicle damages.

Establishes procedure for reporting accidents involving agency vehicles.

Develops and maintains a comprehensive insurance protection program by reviewing and analyzing policies, riders, and endorsements to ascertain the proper insurance coverage.

Sets up specifications for the various types of insurance desired including limits of coverage.

Confers and corresponds with insurance company representatives, employees, and the general public on insurance problems.

Reviews and approves computation of workers' compensation rates and monetary benefits on complex cases to ensure proper disposition.

COMPETENCIES REQUIRED

Knowledge of insurance claims investigation and adjusting practices.

Knowledge of insurance coverages available and the proper methods of application.

Knowledge of legal terminology.

Knowledge of the social, economic, and labor conditions affecting the Workers' Compensation system.

Knowledge of the Iowa Workers' Compensation Act.

Knowledge of national developments relative to Workers' Compensation programs.

Knowledge of casualty insurance claims adjusting practices.

Ability to deal courteously and tactfully with officials in the public and private sectors, and with claimants.

Ability to coordinate and oversee the work of others, as required.

Ability to interpret and originate rules, regulations, policies and procedures.

Ability to evaluate a variety of information and prepare reports of considerable scope and complexity.

Displays high standards of ethical conduct. Exhibits honesty and integrity. Refrains from theft-related, dishonest or unethical behavior.

Works and communicates with internal and external clients and customers to meet their needs in a polite, courteous, and cooperative manner. Committed to quality service.

Displays a high level of initiative, effort and commitment towards completing assignments efficiently. Works with minimal supervision. Demonstrates responsible behavior and attention to detail.

Responds appropriately to supervision. Makes an effort to follow policy and cooperate with supervisors.

Aligns behavior with the needs, priorities and goals of the organization.

Encourages and facilitates cooperation, pride, trust, and group identity. Fosters commitment and team spirit.

Expresses information to individuals or groups effectively, taking into account the audience and nature of the information. Listens to others and responds appropriately.

EDUCATION, EXPERIENCE, AND SPECIAL REQUIREMENTS

Four years of experience in the investigation of insurance claims resulting from accidents;

OR

four years of insurance experience in the area of casualty claims, of which two years must have included experience handling workers' compensation claims; thirty semester hours of college coursework may substitute for one year of the casualty claims experience only with a maximum substitution of two years;

OR

graduation from an accredited school of law;

OR

a combination of education and experience totaling three years in the capacity of a paralegal/legal assistant with emphasis in casualty claims, tort claims, litigation, or workers' compensation, of which at least one year must have been in a formal education program for paralegal or legal assistant.

SELECTIVE CERTIFICATION

For certain designated positions, the Appointing Authority, with Iowa Department of Administrative Services – Human Resources Enterprise approval, may selectively request those applicants possessing a minimum of 12 semester hours of education or 6 months of experience or a combination thereof in one of the following areas...

521 paralegal/legal assistant

767 worker compensation claims

Applicants desiring to be considered for these positions should be sure to list applicable coursework and experience on the application.

Effective Date: 9/15/80 JLC