Hearings Specialist

Texas Mutual Insurance Company•Austin, TX

1d•$76,998 - $95,115•Hybrid

About The Position

Responsible for representing Texas Mutual Insurance Company before the Texas Department of Insurance, Division of Workers' Compensation (DWC), at Benefit Review Conferences and Contested Case Hearings.

Requirements

Bachelor's degree is required 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

Responsibilities

Represents the company’s interests at Benefit Review Conferences (BRCs), including reviewing claim files in internal claim systems to prepare for BRCs, attending BRCs to explain the company’s position and the basis for it, negotiating resolution of disputes with injured workers or their representatives in accordance with the Texas Workers’ Compensation Act and DWC rules when in the company’s best interest, requesting DWC formal Contested Case Hearings (CCHs) on benefits that remain disputed at the conclusion of BRCs, scheduling CCHs via phone with internal Hearings Technical Specialists in accordance with DWC docket, writing and filing BRC reports in the Docket Database for review by supervisor, company adjusters, CCH attorneys, and VP Claim Litigation, scanning and uploading to Content Manager new claim documentation received during a BRC, and communicating with adjusters, CCH attorneys and policyholders in person, by phone or through email, 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.