Hearings Specialist

About the role

Texas Mutual is a great place to work, committed to mutual respect and equal opportunity. This position represents Texas Mutual Insurance Company before the Texas Department of Insurance, Division of Workers' Compensation (DWC).

Responsibilities

• Reviews claim files in internal claim systems to prepare for Benefit Review Conferences (BRCs)
• Attends BRCs to explain the company's position and the basis for it
• Negotiates resolution of disputes with injured workers or their representatives in accordance with the Texas Workers' Compensation Act and DWC rules
• Requests DWC formal Contested Case Hearings (CCHs) on benefits that remain disputed at the conclusion of BRCs
• Schedules CCHs via phone with internal Hearings Technical Specialists in accordance with DWC docket
• Writes and files BRC reports in the Docket Database for review by supervisor, company adjusters, CCH attorneys, and VP Claim Litigation
• Scans and uploads to Content Manager new claim documentation received during a BRC
• Communicates with adjusters, CCH attorneys, and policyholders in person, by phone or through email, about the outcome of the dispute resolution process and claim developments at BRCs
• Facilitates discussions and training sessions with adjusters on claim handling for the dispute resolution process

Qualifications

• Bachelor's degree or equivalent education, training, or experience
• At least two years of experience handling Texas workers' compensation indemnity claims, including at least one year experience handling dispute resolution proceedings or equivalent education, training, or experience
• Current Texas workers’ compensation or all lines adjuster license, or active Texas law license in good standing required
• Valid Texas drivers’ license or available alternate means of transportation