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About the Role

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

• Represents the company’s interests at Benefit Review Conferences (BRCs).
• Reviews claim files in internal claim systems to prepare for BRCs.
• Attends BRCs to explain the company’s position and the basis for it.
• Negotiates 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.
• Requests DWC formal Contested Case Hearings (CCHs) on benefits that remain disputed at the conclusion of BRCs.
• Schedules CCHs via phone with internal Hearings Technical Specialists in accordance with DWC docket.
• Writes and files BRC reports in the Docket Database for review by supervisor, company adjusters, CCH attorneys, and VP Claim Litigation.
• Scans and uploads to Content Manager new claim documentation received during a BRC.
• Communicates 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.

Requirements

• Bachelor's degree or equivalent education, training, or experience.
• At least two years of experience handling Texas workers' compensation indemnity claims.
• 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.
• Valid Texas drivers' license or available alternate means of transportation.

Location

• Texas residency required

Work Type

• Flex-Hybrid

Experience Level

• At least two years of experience handling Texas workers' compensation indemnity claims
• At least one year experience handling dispute resolution proceedings

Education Level

• Bachelor's degree

Salary/Compensations

• $76,998.10 - $95,115.30 Per Year

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

About the Company

• Texas Mutual is deeply committed to creating and maintaining an environment of mutual respect.

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.