Job Description
Job Description
GENERAL DESCRIPTION
The State Office of Risk Management (SORM) is currently seeking a Claims Adjuster who will review and determine compensability on workers' compensation claims. This entry-level position will manage the intake of claim files interviewing claimants, medical providers, and others to determine the compensability of a claim; with opportunities for career advancement/growth. This person will review, approve or reject claims in accordance with the Texas Workers' Compensation Act and division of Workers' Compensation (DWC) Rules and will work under moderate supervision, with limited latitude for the use of independent judgment.
SORM is a unique state agency. We serve the public by directly serving other state entities with their workers' compensation claims, insurance and risk management programs, and continuity of operations (COOP) plans. SORM's unique culture embraces communication, creativity, and critical thinking. We hire results-oriented, curious, innovative, and adaptable people with a strong desire to help our clients, and one another, succeed. SORM continually seeks to enhance the agency's expertise and service by hiring talented people whose aspirations align with the Office's vision. If you are a service-minded professional looking for the stability of state service, we would love to visit with you.
ESSENTIAL POSITION FUNCTIONS
Responds to calls and queries from internal and external customers
Reviews, determines, compensability, and adjusts lost time workers' compensation in accordance with Texas Workers' Compensation Act, DWC rules and regulations and internal procedures
Updates the claim file diary; uses the mainframe system to enter, retrieve and update claim files
Interviews claimants, medical providers, witnesses, and other agency personnel in order to establish compensability
Obtains recorded statements from claimants
Analyzes data and present ideas effectively both orally and in writing
Prepares clear and concise written reports and correspondence to claims, medical consultants and agency personnel
Performs related work as assigned
Maintains relevant knowledge necessary to perform essential job functions
Attends work regularly in compliance with agreed-upon work schedule
Ensures security and confidentiality of sensitive and/or protected information
Complies with all agency policies and procedures, including those pertaining to ethics and integrity
Qualifications:
MINIMUM QUALIFICATIONS Education: Graduation from high school or equivalent
Experience: one year of full-time experience working in the following (or closely related) fields: general office, complex clerical, and secretarial experience. Experience and education may be a substitute for one another
Knowledge of medical terminology
Knowledge of Texas Workers' Compensation law and claims
Skill in handling multiple tasks, prioritizing, and meeting deadlines
Skill in effective oral and written communication
Skill in exercising sound judgment and effective decision making
Ability to receive and respond positively to constructive feedback
Ability to work cooperatively with others in a professional office environment
Ability to obtain and maintain an adjuster's license
Ability to provide excellent customer service
Ability to arrange for personal transportation for business-related travel
Ability to work more than 40 hours as needed and in compliance with the FLSA
Ability to lift and relocate 30 lbs.
Ability to travel (including overnight travel) up to 5%
PREFERRED QUALIFICATIONS Education: Bachelor's degree from an accredited college or university
Knowledge: Advanced knowledge of medical and pharmaceutical terminology
Knowledge: Advanced knowledge of generally accepted medical procedures
Certifications: Associate in Claims or other related insurance certification
TO APPLY
All applications for employment with the State Office of Risk Management must be submitted electronically through A State of Texas application in WorkInTexas
(WIT) must be completed to be considered OR Submit a State of Texas Application for Employment to: Attn: Linda Griffin, State Office of Risk Management, P.O. Box 13777, Austin, TX
78711-3777. Military Crosswalk information can be accessed at
THE SORM IS AN EQUAL OPPORTUNITY EMPLOYER CAPPS, Inc.
Job Tags
Full time, Relocation, Night shift,