Impress employers and recruiters.
Choose from hundreds of resume examples.
Impress employers and recruiters.
Choose from hundreds of resume examples.
About the Role
At Texas Mutual, we are committed to creating a stronger, safer Texas. We are seeking a knowledgeable, service-focused Medical Management Adjuster to join our medical management team. In this role, you will apply medical and claims expertise to help manage workers’ compensation claims involving complex treatment and recovery planning. You will evaluate medical information, identify opportunities for effective care coordination and cost containment, and collaborate with medical directors, nurse case managers, utilization review professionals, providers, employers, and claims partners to support quality outcomes for injured workers.
Responsibilities
- Administer workers’ compensation benefits to injured workers, delivering excellent customer service
- Conduct investigations and make recommendations using your understanding of medical terminology, conditions, and procedures to ensure injured workers receive quality care that is consistent with workers’ compensation best practices
- Thoroughly review and analyze medical maintenance files in collaboration with all levels of medical personnel to coordinate care, resolve barriers, and promote effective recovery
- Maintain caseload/case files and keep meticulous records of claims to ensure regulatory compliance and proper claim handling
Requirements
- High school diploma or equivalent
- 0-2 years of experience adjusting workers' compensation claims required for Level I
- At least 2 years of experience adjusting workers' compensation claims required for Level II
- Current Texas workers’ compensation or all lines adjuster license
- Excellent communication, time management, critical thinking, change management, and self-management skills
Skills
- Medical terminology
- Claims expertise
- Care coordination
- Cost containment
- Communication
- Time management
- Critical thinking
- Change management
- Self-management
Location
- Texas residency required
- Travel to designated office as needed
Work Type
- Flex-Hybrid Work Environment
Experience Level
- 0-2 years of experience adjusting workers' compensation claims required for Level I
- At least 2 years of experience adjusting workers' compensation claims required for Level II
Education Level
- High school diploma or equivalent
- Bachelor's degree (Preferred)
Salary/Compensations
- $27.81 - $86,469.60 Per Year
Benefits
- Annual performance bonus
- 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
- Two personal days
- Day one health, Rx, vision and dental insurance
- Life and disability insurance
- Flexible spending account
- Pet insurance
- Pet Rx discounts
- Free on-site gym
- Fitness classes
- Health and wellness resources
- Free identity theft protection
- Free student loan repayment and refinancing consultation
- Professional development
- Tuition reimbursement
- Employee referral bonus
- Free onsite snacks
About the Company
- Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect.
- Texas Mutual is committed to creating a stronger, safer Texas.
Equal Opportunity
- 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.