CAPPS, Inc.
SORM | Claims Adjuster |
CAPPS, Inc., Austin, Texas, us, 78716
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 customersReviews, determines, compensability, and adjusts lost time workers' compensation in accordance with Texas Workers' Compensation Act, DWC rules and regulations and internal proceduresUpdates the claim file diary; uses the mainframe system to enter, retrieve and update claim filesInterviews claimants, medical providers, witnesses, and other agency personnel in order to establish compensabilityObtains recorded statements from claimantsAnalyzes data and present ideas effectively both orally and in writingPrepares clear and concise written reports and correspondence to claims, medical consultants and agency personnelPerforms related work as assignedMaintains relevant knowledge necessary to perform essential job functionsAttends work regularly in compliance with agreed-upon work scheduleEnsures security and confidentiality of sensitive and/or protected informationComplies with all agency policies and procedures, including those pertaining to ethics and integrityQualifications:
MINIMUM QUALIFICATIONS
Education: Graduation from high school or equivalentExperience: 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 anotherKnowledge of medical terminologyKnowledge of Texas Workers' Compensation law and claimsSkill in handling multiple tasks, prioritizing, and meeting deadlinesSkill in effective oral and written communicationSkill in exercising sound judgment and effective decision makingAbility to receive and respond positively to constructive feedbackAbility to work cooperatively with others in a professional office environmentAbility to obtain and maintain an adjuster's licenseAbility to provide excellent customer serviceAbility to arrange for personal transportation for business-related travelAbility to work more than 40 hours as needed and in compliance with the FLSAAbility 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 universityKnowledge: Advanced knowledge of medical and pharmaceutical terminologyKnowledge: Advanced knowledge of generally accepted medical proceduresCertifications: 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 www.WorkInTexas.com. 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
https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_Insurance.pdf
THE SORM IS AN EQUAL OPPORTUNITY EMPLOYER
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 customersReviews, determines, compensability, and adjusts lost time workers' compensation in accordance with Texas Workers' Compensation Act, DWC rules and regulations and internal proceduresUpdates the claim file diary; uses the mainframe system to enter, retrieve and update claim filesInterviews claimants, medical providers, witnesses, and other agency personnel in order to establish compensabilityObtains recorded statements from claimantsAnalyzes data and present ideas effectively both orally and in writingPrepares clear and concise written reports and correspondence to claims, medical consultants and agency personnelPerforms related work as assignedMaintains relevant knowledge necessary to perform essential job functionsAttends work regularly in compliance with agreed-upon work scheduleEnsures security and confidentiality of sensitive and/or protected informationComplies with all agency policies and procedures, including those pertaining to ethics and integrityQualifications:
MINIMUM QUALIFICATIONS
Education: Graduation from high school or equivalentExperience: 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 anotherKnowledge of medical terminologyKnowledge of Texas Workers' Compensation law and claimsSkill in handling multiple tasks, prioritizing, and meeting deadlinesSkill in effective oral and written communicationSkill in exercising sound judgment and effective decision makingAbility to receive and respond positively to constructive feedbackAbility to work cooperatively with others in a professional office environmentAbility to obtain and maintain an adjuster's licenseAbility to provide excellent customer serviceAbility to arrange for personal transportation for business-related travelAbility to work more than 40 hours as needed and in compliance with the FLSAAbility 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 universityKnowledge: Advanced knowledge of medical and pharmaceutical terminologyKnowledge: Advanced knowledge of generally accepted medical proceduresCertifications: 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 www.WorkInTexas.com. 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
https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_Insurance.pdf
THE SORM IS AN EQUAL OPPORTUNITY EMPLOYER