Hearings Specialist

Texas Mutual Insurance Company; Houston (TX); Hybrid; USD 77,000 - 95,000; Full time

Benefits offered by this job

Annual bonus

Lifestyle Savings Account

401k matching

Student loan repayment

Three weeks vacation

Nine holidays and two personal days

Health insurance

Job summary

Texas Mutual Insurance Company is seeking a qualified professional to support dispute resolution at Benefit Review Conferences and manage claim documentation and communications with adjusters, attorneys, and policyholders.

The role requires at least a Bachelor's degree, two years’ experience in Texas workers’ compensation claims and an active Texas adjuster license or law license. The company offers a flex-hybrid work model, competitive pay, and comprehensive benefits.

Qualifications

• 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.

Responsibilities

• Represents the company’s interests at Benefit Review Conferences (BRCs).
• 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.
• 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.

Education

Bachelor's degree

Job description

About this Position

We're excited you're considering joining a great place to work! Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect and is proud to be an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment without regard to age, race, color, national origin, religion, sex, gender identity, sexual orientation, genetic information, veteran status, or any other basis protected by local, state, or federal law.

Responsibilities & Qualifications

Essential Functions

• 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


• 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

Required Qualifications

• 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

Texas Mutual Pay Transparency

The base pay range is based on the market evaluation of the job and may include pay for multiple levels. Individual base pay within the range is determined by a variety of factors, including experience, performance, education, and demonstration of skills and competencies required for each role. Your recruiter can discuss the full value of our total compensation package with you, including our generous bonus plans and flex-hybrid work model.

Base Pay Range: $76,998.10 - $95,115.30 Per Year

Flex-Hybrid Work Environment

Texas Mutual's flex-hybrid schedule allows you to bring your best self to work by working remotely and collaborating in the office based on business needs. All Texas Mutual employees are required to have Texas residency and travel to their designated office as needed.

Our Benefits

• Annual performance bonus and merit-based pay increase


• Lifestyle Savings Account ($1,000 per year)


• Automatic 4% employer contribution to retirement plan


• 401k plan with 100% employer match up to 6%


• Student loan repayment matching in 401k plan


• Three weeks' time off for vacation


• Nine paid holidays and two personal days each year


• Day one health, Rx, vision and dental insurance


• Life and disability insurance


• Flexible spending account


• Pet insurance and pet Rx discounts


• Free on-site gym, fitness classes, and health and wellness resources


• Free identity theft protection


• Free student loan repayment and refinancing consultation


• Professional development and tuition reimbursement


• Employee referral bonus


• Free onsite snacks

Texas Mutual Insurance Company is the state's leading choice for workers' compensation insurance, with over 40 percent of the market. Thousands of Texas businesses rely on us to help them control their workers' comp costs, protect their employees, and ensure their injured workers receive quality care. Preventing workplace accidents is a foundation of our mission. We have frequently been named one of the Best Companies to Work for in Texas. Our competitive salaries, award-winning benefits package, and employee recognition programs are just a few of the reasons our average employee tenure is 10 years.

If you need an accommodation with any part of the application process, please contact 800-859-5995 and ask to speak with Human Resources.