TDI-Claims Examiner I (Regional Docketing Specialist)

Centralized Accounting and Payroll/Personnel System; Austin (TX); On-site; USD 10,000 - 60,000; Full time

Job summary

The Texas Department of Insurance seeks a TDI-Claims Examiner I to manage disability determinations and workers’ compensation claims. The position involves analyzing claims, responding to public inquiries, and requires a high school diploma and relevant experience. Join TDI for a rewarding career in public service with excellent benefits, including comprehensive medical insurance and state retirement plans.

Benefits

Accrued vacation and sick leave

Free parking

State retirement plan

401(k) and 457 Programs

Free medical insurance

Qualifications

• One year of experience in office practices.
• Knowledge of state laws and administrative procedures.
• Bilingual in English and Spanish preferred.

Responsibilities

• Processes workers’ compensation claims and disputes.
• Coordinates hearing records and prepares files for scanning.
• Assists public inquiries regarding claims.

Skills

Problem solving

Critical thinking

Customer service

Education

High School Diploma or Equivalent

Tools

Microsoft Office

CAPPS systems

Job description

Job Description - TDI-Claims Examiner I (Regional Docketing Specialist) (00050787)

Job Description

TDI-Claims Examiner I (Regional Docketing Specialist) ( 00050787 )

Organization

: TEXAS DEPARTMENT OF INSURANCE

Primary Location

Primary Location

: Texas-Multiple Locations

Work Locations

: Texas - Statewide (454-STATEWIDE) Multiple Locations Multiple Locations 78701

Job

Job

: Business and Financial Operations

Employee Status

Employee Status

: Regular

Schedule

Travel

Travel

: Yes, 5 % of the Time

State Job Code : 2921

Salary Admin Plan : B

Grade : 14

Salary (Pay Basis)

Salary (Pay Basis)

: 3,095.34 - 3,288.50 ( Monthly )

Number of Openings

Number of Openings

: 1

Overtime Status

Overtime Status

: Non-exempt

Job Posting

Closing Date

Closing Date : Ongoing

Description

Do you have a passion for public state service and enjoy making a difference? Don’t miss out on this opportunity. The Texas Department of Insurance (TDI) is hiring! Apply today if you’re looking for a rewarding career in public state service. TDI regulates the insurance industry, administers the Texas workers’ compensation system, educates, and protects consumers. TDI is located at the Barbara Jordan Building at 1601 Congress Avenue in Austin, near the Texas Capitol.

Benefits of working at TDI:

· 96 hours of accrued vacation a year.

· 96 hours of accrued sick leave a year.

· 20+ holidays every year.

· Free parking.

· 401(k) and 457 Programs.

· State of Texas retirement plan with a lifetime annuity through the Employee Retirement System of Texas (ERS).

· Free comprehensive medical insurance for full-time employees and 50% off premium costs for dependents (state pays the other 50%).

· Optional benefits like dental, vision, life insurance, and many more.

· Qualified employer for the Federal Public Service Loan Forgiveness Program.

Claims Examiner I (Regional Docketing Specialist)

This position performs routine (journey-level) disability determination or workers’ compensation work, to include dispute resolution, claims, and analysis. Work involves reviewing and evaluating claims for proceedings. Identifies and directs specific claims-related inquiries to appropriate staff; provides the public with responses to routine questions regarding workers’ compensation rules, policies, forms, and dispute services. Works with the confidentiality of claim file information. May train others. Work may require travel, extended hours, and/or weekends. Works under moderate supervision with limited latitude for the use of initiative and independent judgment.

This position:

· Schedules and reschedules proceedings within the mandated time frames based on assigned rotations.

· Assists in coordinating, assembling, and preparing hearing records and other correspondence such as orders, formal requests, motions, and subpoenas.

· Responsible for producing digital copies of documents for retention purposes.

· Prepares files for scanning.

· Enter and verify claim information in systems.

· Processes documents in a paperless environment and generates claims and proceedings correspondence to eligible parties.

· Provides efficient customer service to all customers related to informal and formal dispute resolution, orders, formal requests, motions, and subpoenas.

· Research and review claims to answer questions from internal and external system participants in person or telephonically, and document customer contacts in the division’s internal computer system.

· Monitors compliance with systematic rotations.

· Performs other duties as assigned.

Qualifications

This position requires:

· High School Diploma or Equivalent.

· One year of experience in office practices and administrative procedures.

· Regular work attendance.

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

Preferences for this position include:

· Experience in disability determination, workers’ compensation claims processing, health care or social work environment, paralegal, and/or dispute resolution.

· Bilingual in English and Spanish language skills (oral).

This position requires demonstrated knowledge of:

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

· Office practices and administrative procedures.

· Word processing and data/key entry.

· Spelling, punctuation, and grammar.

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.

· Planning and decision-making.

· Effective oral and verbal communication.

· The use of automated equipment.

· Providing exemplary 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.

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

Military Occupational Specialty Codes are not identified currently.

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.