State Risk Adjuster

State Risk Adjuster

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State Risk Adjuster

Salary

2,732.00 - $4,682.00 Monthly

Location

Baton Rouge, LA

Job Type

Classified

Remote Employment

Flexible / Hybrid

Job Number

PCF - SRA1 - 206623 - SC

Department

Patients' Compensation Fund Oversight Board

Division

Patient's Compensation Fund

Opening Date

03 / 07 / 2025

Closing Date

3 / 16 / 2025 11 : 59 PM Central

Description

Benefits

Questions

Supplemental Information

About the Patient's Compensation Fund

The Patient's Compensation Fund (PCF) was created in 1975 to provide an affordable and guaranteed medical malpractice coverage system for the private healthcare providers in the state. The Patient's Compensation Fund is an off-State budget entity of the State, which is 100 percent self-funded, and governed by the PCF Oversight Board. The Patient's Compensation Fund provides protection for the healthcare system, keeping costs down, and providing a guaranteed pool of funds to pay those citizens injured from medical malpractice of private care providers.

We are a small agency invested to retain a skilled, productive, engaged, diverse team that we support through training and development, building connections, and supporting a harmonious work life while delivering quality services to the citizens of Louisiana.

About this Position

Incumbent will be accountable in use of independent judgment and decision-making for driving the vision and mission of this Section. Incumbent will possess financial savvy, have strong interpersonal skills, and be results oriented to successfully perform the daily operations required in this Section. Incumbent will maintain a high-level of confidentiality, be effective in professional communication skills, and independently handle complex insurance claims pertaining to individuals injured in medical malpractice cases.

Incumbent received not only specialized training in legal and medical malpractice terms for thorough understanding in the medical malpractice process, procedure, and agency-related State statute, but additionally in the PRISM software systems specialized for PCF claims processing, settlements, and payments.

AN IDEAL CANDIDATE WILL POSSESS THE FOLLOWING COMPETENCIES :

Communicating Effectively : The ability to relay information correctly and appropriately to connect people and ideas.

Following Policies and Procedures : The ability to comply with policies and procedures of the organization as well as State Civil Service rules, and all applicable federal and state laws.

T hinking Critically : The ability to objectively question, analyze, interpret, and evaluate information to form a conclusion.

Acting with Ethics and Integrity : The ability to be consistent, honest, and a trustworthy steward of State resources.

Demonstrating Accountability : The ability to accept ownership for your actions, behaviors, performance, and decisions.

Managing Conflict : The ability to recognize and navigate disagreements in a rational, unbiased, and productive way.

Managing Time : The ability to control your time to increase effectiveness, efficiency, or productivity.

Negotiating Agreements : The ability to reach a consensus when parties may have conflicting interests or perspectives.

NOTE REGARDING THE ADVERSTISED PAY :

The actual starting salary depends on the education and experience of the selected applicant.

No Civil Service test score is required in order to be considered for this vacancy.

To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.

Please identifyALLwork experience with each employer on your job application! Please submit a complete job history. Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.

For further information about this vacancy contact :

Sonja Conerly

Patient's Compensation Fund / Human Resources

PO Box 3718

Baton Rouge, LA 70821

225-342-5200

All prospective new hires will be subject to employment eligibility verification via the federal government’s E-verify system.

As an Equal Opportunity Employer, PCF is committed to a diverse and inclusive workplace prohibiting discrimination on the basis of any non-merit factor.

PCF is a State as a Model Employer (SAME) agency that supports improved employment opportunities for individuals with disabilities.

Minimum Qualifications

MINIMUM QUALIFICATIONS :

Three years of experience in insurance claims adjusting, examining, or investigation; accident investigation, legal research, project management, contract management, or construction management; OR

Six years of full-time work experience in any field; OR

A bachelor's degree.

EXPERIENCE SUBSTITUTION :

Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

Job Concepts

Function of Work :

To train in examining insurance claims, applying benefits utilizing established claims processing systems, and developing recommendations regarding the settlement of claims.

Level of Work : Entry.

Supervision Received :

Close from a State Risk Adjuster 5 or State Risk Adjuster of higher level.

Supervision Exercised :

None.

Location of Work :

Division of Administration and Office of the Governor.

Job Distinctions :

Differs from the State Risk Adjuster 2 by the assignment of less complex claims and claims that are not in litigation.

Examples of Work

Monitors the medical review panel process by requesting updates as necessary and making all appropriate computer entries.

Corresponds with primary insurers, defense attorneys, outside claims adjusters to determine validity, exposure and status of claims. Evaluate incoming medical, investigative and discovery information to determine if layer of primary coverage could be exceeded, referring cases of liability and / or value over $100,000 to supervisor.

Maintains ongoing contact with assigned future medical claimants, their caregivers, vendors and health care providers.

Requests medical reports and bills from the claimant's treating health care providers. Reviews medical reports and claim information to verify the bill submitted relates to medical malpractice claim and all necessary documentation has been received.

Processes requests for payment of related charges after determining if fees are related to the covered condition and are reasonable and customary after review of suggested cuts by senior examiner or supervisor.

Obtains estimates for work done to modify homes and to purchase and modify vehicles for handicapped individuals.

Interacts with the PCF Accounting department for vendor requests and / or changes related to future medical payments.

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity tomake a differencethrough public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.

As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program :

Insurance Coverage More information can be found at

Parental Leave– Up to six weeks paid parental leave

More information can be found

Holidays and Leave – State employees receive the following paid holidays each year :

New Year's Day

Martin Luther King, Jr. Day,

Mardi Gras,

Good Friday,

Memorial Day,

Independence Day,

Labor Day,

Veteran's Day,

Thanksgiving Day and Christmas Day.

• Additional holidays may be proclaimed by the Governor

State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to) :

Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video () to give you more detailed information about their system

Teacher's Retirement System of Louisiana (www.trsl.org),

Louisiana School Employees Retirement System (www.lsers.net), among others

Rate your ability to act with ethics and integrity based on our definition : The ability to be consistent, honest, and a trustworthy steward of State resources.

I have no experience and / or am uncomfortable acting with ethics and integrity

I have limited experience or require assistance to act with ethics and integrity

I can act with ethics and integrity

I can act with ethics and integrity and help others improve their ability to act with ethics and integrity

Explain your rating by providing specific and relevant examples in the box below.

Rate your ability to follow policies and procedures based on our definition : The ability to comply with policies and procedures of the organization as well as State Civil Service rules, and all applicable federal and state laws.

I have no experience and / or am uncomfortable following policies and procedures

I have limited experience or require assistance to follow policies and procedures

I can follow policies and procedures

I can follow policies and procedures and help others improve their ability to follow policies and procedures

Explain your rating by providing specific and relevant examples in the box below.

Rate your ability to manage time based on our definition : The ability to control your time to increase effectiveness, efficiency, or productivity.

I have no experience and / or am uncomfortable managing time.

I have limited experience or require assistance to manage time

I can manage time

I can manage time and help others improve their ability to manage time

Explain your rating by providing specific and relevant examples in the box below.

Required Question

Employer

State of Louisiana

Address

For agency contact information, please refer to

the supplemental information above.

Louisiana State Civil Service, Louisiana, 70802

Phone

866) 783-5462

Website

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Salary : $100,000