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Claims Adjuster II (Liability Claims Adjuster)

Work from home Full-time role Hiring

The Human Resources (HR) Department has an opportunity for a Claims Adjuster II to join the Liability Insurance team with the Risk Management Division located in Riverside. The Claims Adjuster II will manage a caseload of liability claims filed against the County of Riverside. This position performs skilled professional work involving the investigation, evaluation, and resolution of public liability claims. Responsibilities include reviewing, analyzing, and managing a variety of claims—such as malpractice, property, and personal injury—while helping protect the County’s financial and operational interests. The role requires strong analytical skills, sound judgment, and the ability to work independently on complex cases. A competitive candidate will be an experienced claims professional who can quickly adapt to a fast-evolving claims environment and provide immediate operational support. The ideal individual will have experience assessing liability, conducting thorough investigations, interpreting medical and expert reports, and managing claims from intake through resolution. Due to recent changes in PRISM’s program structure, the successful candidate must be able to manage increased claim volume, maintain compliance, and ensure timely and accurate case handling. Strong analytical judgment, excellent communication skills, and the ability to collaborate effectively with multiple departments are essential for success in this role. Meet the Team! The Human Resources Department seeks and develops talented professionals that fit a highly engaged and collaborative culture.

  • Receive, review, and analyze public liability claims—including malpractice, property damage, and personal injury—to determine acceptance or denial.
  • Evaluate medical reports, expert analyses, and supporting documentation to assess liability exposure and the extent of damages.
  • Determine the merit of claims and recommend appropriate settlement, denial, or additional investigative action.
  • Estimate anticipated settlement values; make adjustments and resolve claims within assigned monetary authority.
  • Gather and review data, reports, and claim documentation; request clarification or additional information; monitor claim status and perform required follow-up.
  • Conduct investigations to determine circumstances surrounding claims filed against the County, including interviewing witnesses and inspecting accident, injury, or property damage sites; prepare investigative findings reports.
  • Interview individuals responsible for damage to County property or injuries to County employees to facilitate collections; contact public and private agencies to obtain collections information; recommend actions such as liens or court action to enforce recovery.

Experience: Extensive journey-level experience of at least 5 years reviewing and processing property damage liability claims including investigating, identification and investigation of fraud cases, adjusting and settling a wide variety of claims. Knowledge of: Rules, regulations, and laws regarding personal and property liability including, but not limited to, general provisions of California Vehicle Code, State and Federal Government Codes, laws and statutes and legal decisions pertaining to personal and property liability; Methods and techniques of subrogation recovery; Technical medical terminology related to the cause and treatment of physical injuries; Practices and procedures of insurance reserving, risk and experience analysis and statistical record keeping. Ability to: Gather and evaluate all information pertinent to liability claims and make appropriate recommendations; Establish and analyze all relevant data, effect necessary control plans, and bring all claims to equitable conclusion; Develop action plan necessary to implement recommendations with a minimum of guidance. Other Requirements License: A valid California Driver's License is required at the time of appointment or the ability to arrange transportation for field travel. The incumbent may be required to use a personal vehicle and provide verification of auto insurance coverage as required by the County of Riverside. Job Competencies: Work Performance Measures

  • Effectively analyze and interpret federal and state laws affecting claims.
  • Successfully discern and analyze alternatives in technical situations to assist in problem resolution.
  • Participate appropriately in meetings as directed by the Workers' Compensation Officer or Liability Claims Program Supervisor.
  • Accurately assess and calculate claim settlement costs.
  • Successfully analyze information to determine appropriate strategy.
  • Succinctly and clearly develop written reports and recommendations as assigned.
  • Skillfully utilize computer and other available technology to maintain claims records, supporting documentation and technical/legal information.
  • Meet obligations and commitments.
  • Effectively investigate a wide variety of claims, data sources, regulations and laws governing claims.
  • Take appropriate actions after carefully determining and analyzing all relevant factors.
  • Maintain objectivity and credibility.
  • Effectively maintain expertise in claims areas impacting the County including legal climate and trends.
  • Appropriately utilize creative problem solving, investigative and analysis techniques.
  • Persuasively communicate your findings and recommendations to a variety of audiences including attorneys and insurance representatives.
  • Successfully prioritize conflicting timelines ensuring that each case or project receives appropriate time and consideration.

All applicants must include a copy of their completed certificates required to qualify. Applicants who fail to provide information demonstrating they possess the position requirements may not be considered further in the application process. For questions regarding this recruitment: Please contact Angela Tavaglione at [email protected] or (951) 966-3590. Please allow 1-2 business days for response. Apply To This Job

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