CAPPS, Inc.
TDI-Program Specialist I
CAPPS, Inc., Austin, Texas, us, 78716
Job Description
Do you have a passion for public service and enjoy making a difference?Don't miss out on this opportunity. The Texas Department of Insurance (TDI) is hiring! Apply now if you're looking for a rewarding career in public service. We regulate the insurance industry, administer the Texas workers' compensation system, and educate and protect consumers.
You'll love the benefits of working at TDI:
•Flexible work schedules.
•Hybrid work schedule, if applicable.
•Work-life-balance.
•96 hours of accrued vacation a year.
•96 hours of accrued sick leave a year.
•20+ holidays every year.
•Career advancement opportunities.
•Free parking.
•Free comprehensive medical insurance for full-time employees and 50% off premium costs for dependents (state pays the other 50%).
Before you apply:
Learn about our selection process, our military employment preference, and licensing and credential requirements.
Program Specialist I (Program Specialist)
This position performs routine (journey-level) consultative services and technical assistance work.
Work involves reviewing incoming medical fee disputes and working with the requestors of fee
disputes and other DWC program areas to docket disputes. The position also administers the
program area's archival process following the agency's retention schedule.
This position:
•Dockets incoming disputes after screening them for completeness and accuracy.
•Administers the dispute archiving process following the agency's retention schedule and MFDR's internal policy.
•Makes requests to link insurance carriers and employers to established claims
•Responsible for requesting the creation of a DWC claim number for disputes received without a first report of injury.
•Provides education to stakeholders on incomplete medical fee disputes.
•Answers low-level questions from stakeholders concerning Medical Fee Dispute Resolution (MFDR).
•Creates notification letters for docketed disputes and confidential coversheets for decisions and dismissals.
•Performs other duties as assigned.
Qualifications:
This position requires:
•Graduation from an accredited four-year college or university with major coursework in accounting, business administration, finance, economics, or a related field is generally preferred.
•One year of experience in workers' compensation, medical billing, and reimbursement, or customer service in the medical field.
•Education and experience relevant to position requirements may be substituted for one another on a year-for-year basis.
Additional job details:
This position requires regular work attendance. The position may be eligible for a hybrid work schedule. If eligible, the employee must have a secure, dedicated workspace with reliable broadband internet service. The ideal candidate must be available for weekly meetings and group collaboration via Microsoft Teams and other applications during regular business hours.
Preferences for this position include:
•Experience in workers' compensation, medical billing and reimbursement, and customer service in the medical field.
•This position requires demonstrated knowledge of:
•State laws, rules, procedures, and regulations relevant to job requirements.
•Office practices, data entry, business terminology, mathematics.
•Medical bills
•Explanation of Benefits
•Medical documentation
•Information security
•Laws pertaining to confidentiality of medical records.
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.
•Using Adobe Acrobat.
•Customer service for both internal and external parties.
•Office clerical practices.
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.
•Communicate in a clear and concise manner.
•Prepare and maintain complex records and files.
Veterans
Get help translating your military work experience and training courses into civilian job terms, qualifications/requirements, and skill sets. Redact personal or sensitive information from all attachments.
To receive a veteran's preference, you must submit the following documents, as applicable, with your application.
•Copy of the DD-214; member #4.
•Statement of compensation from the Veteran's Administration or
•Copy of the DD1300.
Applicable Military Occupational Specialty (MOS) codes are included, but not limited to one of the following:
OS
Click or copy and paste the following link into your browser to access Military Crosswalk information:
Military Crosswalk for Occupational Category - Program Management
How to apply:
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.
Do you have a passion for public service and enjoy making a difference?Don't miss out on this opportunity. The Texas Department of Insurance (TDI) is hiring! Apply now if you're looking for a rewarding career in public service. We regulate the insurance industry, administer the Texas workers' compensation system, and educate and protect consumers.
You'll love the benefits of working at TDI:
•Flexible work schedules.
•Hybrid work schedule, if applicable.
•Work-life-balance.
•96 hours of accrued vacation a year.
•96 hours of accrued sick leave a year.
•20+ holidays every year.
•Career advancement opportunities.
•Free parking.
•Free comprehensive medical insurance for full-time employees and 50% off premium costs for dependents (state pays the other 50%).
Before you apply:
Learn about our selection process, our military employment preference, and licensing and credential requirements.
Program Specialist I (Program Specialist)
This position performs routine (journey-level) consultative services and technical assistance work.
Work involves reviewing incoming medical fee disputes and working with the requestors of fee
disputes and other DWC program areas to docket disputes. The position also administers the
program area's archival process following the agency's retention schedule.
This position:
•Dockets incoming disputes after screening them for completeness and accuracy.
•Administers the dispute archiving process following the agency's retention schedule and MFDR's internal policy.
•Makes requests to link insurance carriers and employers to established claims
•Responsible for requesting the creation of a DWC claim number for disputes received without a first report of injury.
•Provides education to stakeholders on incomplete medical fee disputes.
•Answers low-level questions from stakeholders concerning Medical Fee Dispute Resolution (MFDR).
•Creates notification letters for docketed disputes and confidential coversheets for decisions and dismissals.
•Performs other duties as assigned.
Qualifications:
This position requires:
•Graduation from an accredited four-year college or university with major coursework in accounting, business administration, finance, economics, or a related field is generally preferred.
•One year of experience in workers' compensation, medical billing, and reimbursement, or customer service in the medical field.
•Education and experience relevant to position requirements may be substituted for one another on a year-for-year basis.
Additional job details:
This position requires regular work attendance. The position may be eligible for a hybrid work schedule. If eligible, the employee must have a secure, dedicated workspace with reliable broadband internet service. The ideal candidate must be available for weekly meetings and group collaboration via Microsoft Teams and other applications during regular business hours.
Preferences for this position include:
•Experience in workers' compensation, medical billing and reimbursement, and customer service in the medical field.
•This position requires demonstrated knowledge of:
•State laws, rules, procedures, and regulations relevant to job requirements.
•Office practices, data entry, business terminology, mathematics.
•Medical bills
•Explanation of Benefits
•Medical documentation
•Information security
•Laws pertaining to confidentiality of medical records.
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.
•Using Adobe Acrobat.
•Customer service for both internal and external parties.
•Office clerical practices.
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.
•Communicate in a clear and concise manner.
•Prepare and maintain complex records and files.
Veterans
Get help translating your military work experience and training courses into civilian job terms, qualifications/requirements, and skill sets. Redact personal or sensitive information from all attachments.
To receive a veteran's preference, you must submit the following documents, as applicable, with your application.
•Copy of the DD-214; member #4.
•Statement of compensation from the Veteran's Administration or
•Copy of the DD1300.
Applicable Military Occupational Specialty (MOS) codes are included, but not limited to one of the following:
OS
Click or copy and paste the following link into your browser to access Military Crosswalk information:
Military Crosswalk for Occupational Category - Program Management
How to apply:
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.