Hearings Specialist

Texas Mutual Insurance Company; Irving (TX); Hybrid; USD 73,000 - 99,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Paid time off

Bonus program

Flexible spending account

Job summary

Texas Mutual Insurance Company is hiring for a role representing the company before the Texas Department of Insurance, Division of Workers' Compensation. You will handle Benefit Review Conferences, Contested Case Hearings, and related dispute resolution.

The position requires a Texas adjuster license or law license, a bachelor's degree, and experience with Texas workers' compensation claims. Flex-hybrid work environment with base pay discussed with recruiters.

Qualifications

• Bachelor's degree or equivalent education, training, or experience
• At least two years of experience handling Texas workers' compensation indemnity claims, including dispute resolution
• Current Texas workers’ compensation or all lines adjuster license, or active Texas law license in good standing
• Valid Texas driver’s license or alternative transportation

Responsibilities

• Review claim files in internal claim systems to prepare for BRCs
• Attend BRCs to explain the company’s position and basis
• Negotiate resolution of disputes with injured workers or representatives per Texas law
• Request DWC Contested Case Hearings on remaining disputed benefits
• Schedule CCHs with Hearings Technical Specialists per DWC docket
• Write and file BRC reports for review by supervisors and attorneys
• Scan and upload new claim documentation received during a BRC
• Communicate outcomes to adjusters, attorneys and policyholders via phone/email
• Facilitate discussions and training with adjusters on dispute resolution process

Skills

Dispute resolution

Negotiation

Communication

Education

Bachelor's degree or equivalent

Job description

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.

About This 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.

Responsibilities & Qualifications

Essential Functions:

• 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