State Risk Adjuster 2-4

Posting number: PCF-SRA 2-4-225553-TC

Department: Patients' Compensation Fund Oversight Board

Division: Patient's Compensation Fund

Job classification: STATE RISK ADJUSTER 2

Posting type: Open & Promotional

Categories: Risk Management, Customer Service, Office and Administrative Support, Insurance

Summary

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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 self-funded state entity, operating independently of the main state budget, 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 in retaining 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

The incumbent is responsible for fulfilling the legislative mandate of the Patient's Compensation Fund by ensuring efficient and economical claims handling so that affordable excess medical coverage remains available to licensed health care providers throughout the State of Louisiana. The incumbent works closely with the primary insurance carrier and defense attorney to determine the facts of each case and evaluate the Patient's Compensation Fund's potential exposure. The incumbent receives on-the-job training, including specialized training in agency-specific software and procedures.

This position directly reports to and receives broad supervision from the State Risk Adjuster 5 (Claims Supervisor) and receives direction from the Claims Manager, while exercising autonomy and discretion on assignments.

The ideal candidate should possess the following competencies:
Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement. Demonstrating Accountability: The ability to take ownership of actions, behaviors, performance, decisions, and outcomes.
Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.
Managing Stakeholders: The ability to identify key stakeholders, manage relationships, and align interests to move work forward.
Acting with Ethics and Integrity: The ability to make choices that reflect ethical standards, integrity and honesty, regardless of circumstances or personal benefit.
Negotiating Agreements: The ability to reach fair, mutually beneficial outcomes through ethical negotiation that builds trust and supports shared goals.

Examples of duties

Four 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 plus one year of experience in insurance claims adjusting, examining, or investigation; accident investigation, legal research, project management, contract management, or construction management; OR

A bachelor's degree plus one year of experience in insurance claims adjusting, examining, or investigation; accident investigation, legal research, project management, contract management, or construction management; OR

An advanced degree in risk management or insurance, business or public administration, safety or legal studies, construction management, or a health services field.

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.

Qualifications

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Supplemental information

Job Duties:

• Procure documentation in support of claims being presented to the Patient Compensation Fund.
• Reviews the information to establish a claim evaluation.
• Secures settlement authority.
• Negotiates each claims case.
• Prepares an executive report for the PCF Oversight Board.
• Finalizes the settlement, and issue payment.
• Obtains investigative information, identifies and investigates liens, potential subrogation and possible fraud.
• Evaluates exposure to the Fund based on potential liability.
• Supervises activities of contract attorneys.

Position Specific Details:
Appointment type: Classified, Promotional.
This position is open to current classified permanent employees at the LA Patients Compensation Fund.
Career Progression: This position is part of a Career Progression Group and may be filled as a State Risk Adjuster 2, State Risk Adjuster 3, or State Risk Adjuster 4.
Work Schedule: Monday - Friday, Overtime as needed.
Compensation: This position is eligible for premium pay of up to $2.00 per hour.

NOTE REGARDING THE ADVERTISED PAY:

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

Please click on the links below to learn more about each job level:

State Risk Adjuster 2: https://apps01.civilservice.louisiana.gov/onestopjobinfo/DisplayJobSpec.aspx?JobCode=167590

State Risk Adjuster 3: https://apps01.civilservice.louisiana.gov/onestopjobinfo/DisplayJobSpec.aspx?JobCode=167600

State Risk Adjuster 4: https://apps01.civilservice.louisiana.gov/onestopjobinfo/DisplayJobSpec.aspx?JobCode=167610

How To Apply:

No Civil Service test score is required 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.

Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience/education).Please identify ALL work experience with each employer on your job application! Resumes WILL NOT be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete. Please include all education and work experience in order to be considered, as pay is DOE (dependent upon experience).

For further information about this vacancy, contact:

Taylor Colar

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 based on any non-merit factor.

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