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STATE RISK ADJUSTER 1

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STATE RISK ADJUSTER 1

Salary

$2,732.00 - $4,682.00 Monthly

Location

Baton Rouge, LA

Job Type

Classified

Job Number

PCF-SRA1 Claims-213242-TC

Department

Patients' Compensation Fund Oversight Board

Opening Date

09/25/2025

Closing Date

10/6/2025 11:59 PM Central

+ Description

+ Benefits

+ Questions

About this Job

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 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 for the 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 a thorough understanding of 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.

Learning Actively:The ability to acquire necessary knowledge and skills to improve performance and achieve organizational goals.

Using Data: The ability to use relevant and valid data to inform a recommendation for action.

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.

Pursuing Professional Development:A personal commitment to take advantage of opportunities to increase your professional knowledge, skills, and abilities.

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 Specification

The official job specifications for this role, as defined by the State Civil Service, can be found here. (https://apps01.civilservice.louisiana.gov/onestopjobinfo/DisplayJobSpec.aspx?JobCode=167580)

Job Duties and Other Information

Job Duties:

+ Monitor the medical review panel process, requesting updates as necessary and making all appropriate computer entries.

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

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

+ Requests medical reports and bills from treating health care providers. Reviews medical reports and claim information to verify 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 reasonable and customary, and disallows unrelated or unnecessary charges after review of suggested cuts by a senior examiner.

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

Position-Specific Information:

Appointment Type: Full time, Classified. Probational or promotional.

Work Schedule: Monday - Friday, overtime as needed.

Compensation: Depends on the qualifications of the selected candidate. Position qualifies for premium pay.

Louisiana is a State As a Model Employer (SAME) that supports the recruitment, hiring, and retention of individuals with disabilities.

How To Apply:

No Civil Service test scoreis 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 this job title must be included in the application (i.e., relevant, detailed experience/education). Resumeswill notbe 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:

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.

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 https://info.groupbenefits.org/

Parental Leave– Up to six weeks paid parental leave

More information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx

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 (https://lasersonline.org/wp-content/uploads/2016/07/Your\_Retirement\_System.mp4) 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

01

Rate your ability to communicate effectively based on our definition: The ability to relay information correctly and appropriately to connect people and ideas. 1= I have no experience and/or am uncomfortable communicating effectively 2= I have limited experience or require assistance to communicate effectively 3= I can communicate effectively 4= I can communicate effectively and help others improve their communication

02

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

03

Rate your ability to demonstrate accountability based on our definition: The ability to accept ownership for your actions, behaviors, performance, and decisions. 1= I have no experience and/or am uncomfortable demonstrating accountability 2= I have limited experience or require assistance to demonstrate accountability 3= I can demonstrate accountability 4= I can demonstrate accountability and help others improve their ability to demonstrate accountability

04

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

05

Rate your ability to manage conflict based on our definition: The ability to recognize and navigate disagreements in a rational, unbiased, and productive way. 1= I have no experience and/or am uncomfortable managing conflict 2= I have limited experience or require assistance to manage conflict 3= I can manage conflict 4= I can manage conflict and help others improve their ability to manage conflict

06

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

http://agency.governmentjobs.com/louisiana/default.cfm

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