Do you have a passion for public service and enjoy making a difference? Don’t miss out on this opportunity. The Texas Department of Insurance (TDI) is hiring! Apply now if you’re looking for a rewarding career in public service. We regulate the insurance industry, administer the Texas workers’ compensation system, and educate and protect consumers.

You’ll love the benefits of working at TDI:

• Flexible work schedules.
• Hybrid telecommuting.
• Work-life balance.
• 96 hours of accrued vacation a year.
• 96 hours of accrued sick leave a year.
• 20+ holidays every year.
• Career advancement opportunities.
• Free parking.
• Free comprehensive medical insurance for full-time employees, and the state pays 50% of the premium costs for dependents.

Claims Examiner II (Senior Exam Request Specialist)

The Senior ERS is selected by and reports to the Director of Designated Doctor Operations (DDO). The Senior ERS performs moderately complex (journey-level) workers’ compensation work. Work involves reviewing and evaluating claims for benefits and extensive data entry. May provide guidance to others. Works under general supervision with moderate latitude for the use of initiative and independent judgment.

This position:

• Reviews and evaluates requests for designated doctor examinations addressing all issues including other similar issues where any box is checked that involves finding a board-certified physician; makes determinations regarding the approval or denial of these designated doctor examination requests in accordance with applicable statutes, rule, policies, and procedures.
• Research and reviews workers’ compensation claims and correspondence in various databases and the TXCOMP Claims and Coverage Systems.
• Analyzes reported injuries and medical conditions to determine qualified designated doctors to assign to claims and provides proper documentation regarding assignments.
• Coordinates the examination between the designated doctor and the injured employee.
• Prepares forms, letters, and supporting materials to complete the request for designated doctor examination process.
• May train others and assist ERS staff. Assists in identifying and reporting potential fraud or non-compliance activities of system participants.
• Performs other duties as assigned.

This position requires:

• Thirty college hours in business administration, social work, or in a related field.
• One and a half years’ experience in disability determination, workers’ compensation, or insurance.
• Experience and education may be substituted for one another on a year-for-year basis.

Additional job details:

This position may be eligible for hybrid telecommuting. Employees must have a secure, dedicated workspace with Internet service, ability to maintain a reliable consistent work schedule, and be available for weekly meetings and group collaboration via Microsoft Teams and other applications during regular business hours.

Preferences for this position include:

• Experience in a health care or social work environment.
• Paralegal and/or dispute resolution experience.
• Understanding of TDI/DWC rules and workers’ compensation claims process.
• Bilingual in English and Spanish (oral and written).

This position requires demonstrated knowledge of:

• Relevant Texas Workers’ Compensation Acts and Rules.
• Office practices, data entry, business terminology, spelling, grammar, mathematics.
• Personal computer software such as Microsoft Office Word and Excel software applications.

This position requires demonstrated skill in:

• Effectively communicating both verbally and in writing.
• Decision making, planning and problem solving.
• Customer Service.
• The use of automated equipment.
• Using personal computers sufficient to enter and extract data from related systems and programs.

This position requires the demonstrated ability to:

• Handle multiple tasks simultaneously and manage conflicting priorities to meet deadlines.
• Perform extensive data entry for long periods of time.
• Understand and carry out complex instructions.
• Prepare and maintain complex records and files.
• Make decisions in accordance with rules, regulations, and procedures.
• Apply critical thinking to analyze and solve work problems.
• Write reports and present complex information to a variety of audiences.
• Maintain confidentiality.
• Communicate in a clear and concise manner.
• Establish and maintain effective working relationships at all organizational levels, including internal and external customers.
• Lift and carry up to 50 lbs. (if applicable).

Veterans:

Click or copy and paste this link into your browser: www.texasskillstowork.com for help translating your military work experience and training courses into civilian job terms, qualifications/requirements, and skill sets. Redact personal or sensitive information from all attachments.

To receive a veteran’s preference, you must submit the following documents, as applicable, with your application.

• Copy of the DD-214; member #4.
• Statement of compensation from the Veteran’s Administration or
• Copy of the DD1300.

Job Type: Full-time

Pay: $3,309.00 per month

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work Location: Hybrid remote in Austin, TX 78701

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