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 & Qualifications

Essential Functions:

Represents the company’s interests at Benefit Review Conferences (BRCs), including:

• Reviewing claim files in internal claim systems to prepare for BRCs
• Attending BRCs to explain the company’s position and the basis for it
• Negotiating 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
• Requesting DWC formal Contested Case Hearings (CCHs) on benefits that remain disputed at the conclusion of BRCs
• Scheduling CCHs via phone with internal Hearings Technical Specialists in accordance with DWC docket
• Writing and filing BRC reports in the Docket Database for review by supervisor, company adjusters, CCH attorneys, and VP Claim Litigation
• Scanning and uploading to Content Manager new claim documentation received during a BRC
• Communicating 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

Required Qualifications:

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

Texas Mutual Pay Transparency

The base pay range is based on the market evaluation of the job and may include pay for multiple levels. Individual base pay within the range is determined by a variety of factors, including experience, performance, education, and demonstration of skills and competencies required for each role. Your recruiter can discuss the full value of our total compensation package with you, including our generous bonus plans and flex-hybrid work model.

Base Pay Range: $76,998.10 - $95,115.30 Per Year

Flex-Hybrid Work Environment:

Texas Mutual’s flex-hybrid schedule allows you to bring your best self to work by working remotely and collaborating in the office based on business needs. All Texas Mutual employees are required to have Texas residency and travel to their designated office as needed.

Our 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