Job Description

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 work schedule, if applicable.

• 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 50% off premium costs for dependents (state pays other 50%).

Working at TDI offers many benefits. TDI is a qualifying organization for the Federal Public Service Loan Forgiveness Program. TDI also offers a lifetime monthly retirement annuity as well as 401(k) and 457 Programs under the Employees Retirement System of Texas. TDI is located at the Barbara Jordan Building at 1601 Congress Ave in Austin. The innovative structure is part of the state's Capitol Complex project.

Before you apply:

Learn about our selection process, our military employment preference, and licensing and credential requirements.

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 guide 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, rules, policies, and procedures.

• Researches 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 the designated doctor examination process.

• Assists in identifying and reporting potential fraud or non-compliance activities of system participants.



Qualifications:

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.

• Education and experience relevant to position requirements may be substituted for one another on a year-for-year basis.

Additional job details:

This position requires regular work attendance. The position may be eligible for a hybrid work schedule. If eligible, the employee must have a secure, dedicated workspace with reliable broadband internet service. The ideal candidate must 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:

• State laws, rules, procedures, and regulations relevant to job requirements.

• 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:

• 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.

• Effectively communicating both verbally and in writing.

• 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.

• 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.

Veterans

Get 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.

Applicable Military Occupational Specialty (MOS) codes are included, but not limited to one of the following:

Military Occupational Specialty Codes are not available currently.

Click or copy and paste the following link into your browser to access Military Crosswalk information:

Military Crosswalk for Occupational Category - Insurance (texas.gov)

How to apply:

All applications must contain complete job histories, including job title, dates of employment, name of employer, manager's name and phone number, and a description of duties performed. We may reject applications that do not include all the required information. Resumes do not substitute for this required information.

Submitted through Work in Texas:

Work in Texas (WIT) applicants must complete supplemental questions to be considered for the position. To complete supplemental questions, go to CAPPS Career Center to register or log in and access your profile.