Insurance Coverage Officer

This position adjusts insurance claims (Automobile and Property & Casualty) for the State of Delaware its agencies school districts higher education institutions and its employees.

Essential functions are fundamental core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive incumbents can complete job duties of similar kind not specifically listed here.

• Performs coverage analysis investigation evaluation negotiation and deposition of insurance claims for all lines of insurance except health life and disability managed and paid on behalf of the State of Delaware. This includes conducting research collecting data performing investigations mediating disputes and negotiating claim settlements when appropriate.
• Provides expertise on behalf of the State on insurance programs and other insurance claims questions.
• Makes proper determination of coverage legal liability and damages to effect settlement of claims.
• Directs contracted appraisers investigators rehabilitation specialists adjusters and attorneys in adjudicating claims.
• Prepares Request For Proposals (RFPs) for insurance coverage and other contracted services.
• Researches federal and state statutes and insurance regulations and keeps abreast of new and/or revised pending legislation for potential impact on the State.
• Prepares files with required forms exhibits and reports to assist in litigation management and maintains a working diary for each assigned claim file.
• Maintains records and reports of the self-insurance fund.
• Ensures all subrogation is promptly identified the responsible party is documented in an automated information system and subrogation letters are sent to responsible parties.

JOB REQUIREMENTS for Insurance Coverage Officer
Applicants must have education training and/or experience demonstrating competence in each of the following areas:

1. Possession of a Delaware Insurance Adjusters License inone or more of the following lines of authority: Casualty Motor Vehicle Workers Compensation or Property.
2. Six months experience in investigating evaluating and negotiating insurance claims and making determinations for coverage legal liabilities and damages affecting the settlement of claims.
3. Three years experience in interpreting insurance laws rules regulations standards policies and procedures.
4. Six months experience in narrative report writing.
5. Knowledge of medical terminology.

Applicants must be legally authorized to work in the United States. The State of Delaware Executive Branch participates in the Federal E-Verify system where the State will provide the federal government with each new hires Form I-9 information to confirm that you are authorized to work in the U.S. For more information refer to our job seeker resources.

To learn more about the comprehensive benefit package please visit our website at Process

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