OIEC - Early Assistance Advocate for Injured Emplo
About the role
Early Assistance Advocate for Injured Employees (Ombudsman I) - Lufkin. An Early Assistance Advocate (Ombudsman I) works with senior Ombudsmen who advocate, assist, and educate injured employees of Texas. The Early Assistance Advocate will utilize early intervention strategies to assist injured employees prior to hearings. Being an Early Assistance Advocate involves: assisting the injured employee one-on-one; answering questions from the injured employee; reviewing claims for medical and income benefits; studying and analyzing the case background on each claim; gathering and evaluating information (including medical records and letters from doctors); preparing and responding to requests for Designated Doctor examinations; evaluating and implementing strategies to resolve a claim early; reporting and referring complaints; and tracking and providing information and claim status. The Early Assistance Advocate works under moderate supervision, with limited latitude for the use of initiative and independent judgement. Travel Required: 25%.
Responsibilities
- educates the injured employee about the workers' compensation dispute process and workers' compensation law/rules
- advocates for expedient resolution of a claim by assembling evidence (e.g., medical records, causation letters, etc.) needed for insurance carrier determinations and/or in anticipation of benefit proceedings
- contacts insurance carriers and medical providers to identify and resolve disputes
- assists with referrals to social services with other state agencies
- provides assistance in filing claims; assists with obtaining supporting claim documentation from doctors
- routinely contacts injured employees to provide status updates and discuss upcoming events
- documents customer contact in computer system
- answers general customer service questions
- performs other duties, as assigned
Qualifications
- associate's degree from an accredited college or university
- one year experience in claims management, insurance, casework, healthcare, social work, law office (paralegal/legal assistant) or workers' compensation
- Note: Relevant experience may be substituted for education on a year-for-year basis.
- Or graduation from high school or equivalent
- two years of experience working for the Office of Injured Employee Counsel
- If you hold a current law license, you must surrender it upon hire.
- Candidate must reside in Texas or be able to relocate to Texas by the start date.
- OIEC does not sponsor or assume sponsorship of an employment visa.
Skills
Knowledge: Microsoft Word, Excel, and Outlook
Skill: assisting the public, conflict resolution, handling and solving problems, report writing and records maintenance principles and practices, interpreting and explaining laws and regulations, data entry and retrieval, customer service, use of correct grammar, punctuation, and spelling
Ability: manage multiple, competing priorities; establish and maintain effective working relationships with a variety of individuals and groups including injured employees and fellow staff members; communicate effectively both verbally and in writing with all levels of employees and the public