TDI - DWC - Hearings - Claims Examiner I (Regional

Do you have a passion for public state service and enjoy making a difference? The Texas Department of Insurance, Division of Workers Compensation (DWC) administers and operates the Texas workers compensation system. DWC regulates the workers compensation system, settles disputes, provides customer service, promotes workplace safety, and ensures compliance with state laws. DWC has 20 offices across the state of Texas, with headquarters in the Capitol Complex, Barbara Jordan Building at 1601 Congress Avenue in Austin, near the Texas Capitol.

Benefits

• Flexible work schedules
• 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
• 401(k) and 457 Programs
• State of Texas retirement plan with a lifetime annuity through the Employee Retirement System of Texas (ERS)
• Free comprehensive medical insurance for full-time employees and 50% off premium costs for dependents (state pays other 50%)
• Optional benefits like dental, vision, life insurance, and many more
• Qualified employer for the Federal Public Service Loan Forgiveness Program

About the role

This position performs routine (journey-level) disability determination or workers compensation work, to include dispute resolution, claims and analysis. Work involves reviewing and evaluating claims for proceedings. Identifies and directs specific claims related inquiries to appropriate staff; provides the public with responses to routine questions regarding workers compensation rules, policies, forms, and dispute services. Works with the confidentiality of claim file information. May train others. Work may require travel, extended hours and/or weekends. Works under moderate supervision with limited latitude for the use of initiative and independent judgment.

The selected candidate will be able to work from one of the following office locations: Amarillo, Austin, Beaumont, Corpus Christi, Denton, Houston East, Laredo, Lubbock, Midland, San Antonio, or Weslaco.

Responsibilities

• Schedules and reschedules proceedings within the mandated time frames based on assigned rotations
• Assists in coordinating, assembling, and preparing hearing records and other correspondence such as orders, formal requests, motions, and subpoenas
• Responsible for producing digital copies of documents for retention purposes
• Prepares files for scanning
• Enters and verifies claim information in systems
• Processes documents in a paperless environment and generates claims and proceedings correspondence to eligible parties
• Provides efficient customer service to all customers related to informal and formal dispute resolution, orders, formal requests, motions, and subpoenas
• Researches and reviews claims to answer questions from internal and external system participants in person or telephonically, and documents customer contacts in the division’s internal computer system
• Monitors the compliance of systematic rotations
• Performs other duties as assigned

Requirements

• High School Diploma or Equivalent
• One year experience in office practices and administrative procedures
• Regular work attendance
• Travel may be required for up to 5% of the time
• If travel is 10% or more, you must maintain a state of Texas Driver’s License

Education and experience may be substituted for one another on a year-for-year basis.

Preferred Qualifications

• Experience in disability determination, workers compensation claims processing, health care or social work environment, paralegal and/or dispute resolution
• Bilingual in English and Spanish language skills (oral)

Skills

This position requires demonstrated knowledge of:

• State laws, rules, procedures, and regulations relevant to job requirements
• Office practices and administrative procedures
• Word processing and data/key entry
• Spelling, punctuation, and grammar

This position requires demonstrated skill in:

• Problem solving and critical thinking
• Using Microsoft Office software applications, including Word, Excel, Outlook, and SharePoint
• Using personal computers sufficient to enter and extract data from related systems and programs such as Centralized Accounting Payroll and Personnel (CAPPS) and other systems required to perform the job
• Planning and decision-making
• Effective oral and verbal communication
• The use of automated equipment
• Providing exemplary customer service

This position requires the demonstrated ability to:

• Communicate and work effectively with a wide range of people with varied skills, knowledge, and backgrounds
• Maintain the confidentiality of sensitive information
• Analyze and solve work-related problems and work independently on a variety of administrative work and technical assignments
• Manage and coordinate multiple tasks and priorities to meet necessary deadlines
• Work both independently and as a team player