Workers' Compensation Claims Adjuster IV, or V - OCC Division - Austin, TX

Texas Department of Transportation

$75K — $106K *
Finance & Insurance
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Business Administration, Insurance, or a related field.
  • 3+ years of experience in claims adjusting (4+ years for Level V).
  • Texas Insurance Adjuster license (All Lines or Worker’s Compensation) required.
  • Valid driver’s license for state vehicle operation.
  • Experience with Origami Risk Management platform is a plus.

Responsibilities

  • Investigate and adjust Texas worker's compensation claims.
  • Evaluate compensability of claims and make independent decisions.
  • Negotiate settlements and recommend risk prevention measures.
  • Prepare written reports and maintain accurate claim records.
  • Facilitate depositions, activity checks, and courtroom exhibits for litigation.
  • Conduct safety meetings and present at district safety meetings.
  • Assist with special risk management projects as needed.

Benefits

  • Comprehensive retirement plans.
  • Flexible work schedules to promote work-life balance.
  • 100% health premiums paid for full-time employees.
  • On-the-job training and career development opportunities.
  • Tuition assistance for further education.
  • Holistic wellness programs with leave incentives.
  • Family-friendly policies and programs.
Full Job Description
Position Information

If you're a pro at handling Texas worker's compensation claims and can work multiple claims without breaking a sweat, let's talk. The Texas Department of Transportation, a Self-Insured state entity, is looking for a senior-level adjuster to investigate and handle in-house claims as part of its Occupational Safety Division. Familiarity with the Origami Risk Management platform or similar is a huge plus. Caseloads average approximately 60 claims per adjuster. Some travel within the state is expected.

Stassney Campus https://youtu.be/u42vEZacDgA

  • Workers' Compensation Claims Adjuster (Loss Control Representative) IV- B22 - Salary Range $75,000.00 - $90,000.00
  • Workers' Compensation Claims Adjuster (Loss Control Representative) V- B24 - Salary Range $80,000.00 - $106,634.00


The Texas Department of Transportation reserves the sole right in determining the level of position based on the applicant's work experience, education, skill level, and all other appropriate factors, and based on business needs.

Benefits and Perks

At TxDOT, we value work-life balance and are committed to providing our employees with a comprehensive range of benefits and programs, including:

  • Retirement Plans
  • Alternative and/or Flexible Work Schedules
  • Paid Leave and Holidays
  • Health Premiums paid at 100% for Full-Time Employees
  • On-the-Job Training
  • Tuition Assistance Program
  • Holistic Wellness Program with Leave Incentives
  • Career Development and Advancement Opportunities
  • Family-Friendly Policies and Programs


For a complete list of our total compensation package please visit our Total Compensation Package website

To view benefits available to all State of Texas employees visit Benefits at a Glance | ERS (texas.gov)

Position Description

Loss Control Represent IV and V :

Investigates and adjusts workers compensation and potentially tort and liability claims against the Department. Investigates and evaluates the compensability of workers' compensation claims. Makes independent decisions on claims, including settlement authority. Work requires contact with Department employees, medical providers and law enforcement personnel.

Essential Duties:

Loss Control Represent IV :

  • Recommends risk avoidance, prevention, reduction and safety assessment measures to senior managers for the Department's risk management programs.
  • Assists investigative agencies by facilitating depositions, running activity checks, collection information and preparing courtroom exhibits if claims require litigation.
  • Conducts and/or attends safety meetings to answer questions from employees and managers.
  • Conducts evaluations and completes written reports as needed and/or requested.
  • Makes presentations at district safety meetings and new employee orientation on specific topics.
  • Negotiates settlement of claims.
  • Performs and completes special projects related to risk management as needed and/or requested.
  • Prepares and submits written reports of activities; maintains records and files.
  • Represents the Department at claim conferences and hearings and evaluates the compensability of cases.
  • Performs other jobs responsibilities as assigned.


Loss Control Representative V:

All the Above and:

  • Performs complex analysis of factual and legal situations.
  • Recommends risk avoidance, prevention, reduction and safety assessment measures to senior managers for the Department's risk management programs.


Minimum Qualifications:

Loss Control Represent IV :

Education:

  • Bachelor's Degree in Business Administration, Insurance or related field.
  • Relevant work experience may be substituted for degree on a year per year basis . Substitutions for Minimum Qualifications


Experience:

  • 3 years claims adjusting.
  • Experience can be satisfied by full time or prorated part time equivalent.
  • Related graduate level education may be substituted for experience on a year per year basis.


Licenses and Certifications:

  • Valid driver's license. This position requires driving a state vehicle.
  • Must have a Texas Insurance Adjuster license in: All Lines OR Worker's Compensation


Loss Control Represent V :

Education:

  • Bachelor's Degree in Business Administration, Insurance or related field.
  • Relevant work experience may be substituted for degree on a year per year basis . Substitutions for Minimum Qualifications


Experience:

  • 4 years claims adjusting.
  • Experience can be satisfied by full time or prorated part time equivalent.
  • Related graduate level education may be substituted for experience on a year per year basis.


Licenses and Certifications:

  • Valid driver's license. This position requires driving a state vehicle.
  • Must have a Texas Insurance Adjuster license in: All Lines OR Worker's Compensation
Competencies:

Loss Control Represent IV:

Considerable Knowledge of:

  • Auditing and investigative methods, practices and procedures
  • Contract claims, dispute resolutions and adjustments techniques
  • Applicable laws, rules, and regulations
  • Negotiation practices


Expert skill in:

  • Speaking to present images and ideas in a clear, concise, organized, and interesting manner to optimize audience understanding and keep the group focused
  • Preparing technical/statistical reports
  • Conducting investigations


Proficient skill in:

  • Public relations for maintaining effective working relationships with individuals and groups, both internal and external
  • Maintaining effective working relationships with others
  • Preparing and maintaining confidential and sensitive records, files, and reports
  • Training in a classroom, office, or field environment
  • Developing and giving presentations
  • Using computers, applicable programs, applications, and systems


Other Attributes:

  • Exercises logic and reasoning to define problems, establish facts and draw valid conclusions; makes decisions that support business objectives and goals
  • Shows initiative and action beyond what is required to improve products or services; is self-starting and completes assignments independently without constant supervision


Loss Control Represent V:

All the Above and :

  • Extensive knowledge of medical terminology
Physical Requirements and Working Conditions:

Loss Control Represent IV or V:

  • Sedentary work: Lift up to 10 lbs at a time and occasionally carry files/small tools
  • Light work: Lift up to 20 lbs at a time and frequently lift or carry objects up to 10 lbs
  • Standing-prolonged periods of time
  • Repetitive Motion-substantial movements of the wrists, hands, and/or fingers
  • Close Visual Acuity-work includes data/figures; view a computer screen; extensive reading

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