Job Title: Early Assistance Advocate for Injured Employees (Ombudsman I)
Job Responsibilities:
An Early Assistance Advocate (Ombudsman I) is responsible for advocating, assisting, and educating injured employees in Texas regarding their workers’ compensation claims. The role involves utilizing early intervention strategies to assist injured employees before hearings. Key responsibilities include:
- Assisting injured employees one-on-one
- Answering questions from injured employees
- Reviewing claims for medical and income benefits
- Studying and analyzing the case background on each claim
- Gathering and evaluating information, including medical records and doctors' letters
- Preparing and responding to requests for Designated Doctor examinations
- Evaluating and implementing strategies to resolve claims early
- Reporting and referring complaints
- Tracking and providing information and claim status
- Educating injured employees about the workers’ compensation dispute process and law/rules
- Assembling evidence needed for insurance carrier determinations or benefit proceedings
- Contacting insurance carriers and medical providers to identify and resolve disputes
- Assisting with referrals to social services with other state agencies
- Providing assistance in filing claims and obtaining supporting documentation from doctors
- Routinely contacting injured employees to provide status updates and discuss upcoming events
- Documenting customer contact in the computer system
- Answering general customer service questions
- Performing other duties as assigned
Education and Experience Information:
- is required.
- One year of experience in claims management, insurance, casework, healthcare, social work, law office (paralegal/legal assistant), or workers’ compensation is required. Education and relevant experience may be substituted for one another on a year-for-year basis.
This position requires knowledge of:
- Microsoft Word, Excel, and Outlook
This position requires demonstrated skill in:
- Assisting the public
- Conflict resolution
- Handling and solving problems
- Report writing and records maintenance principles and practices
- Interpreting and explaining laws and regulations
- Data entry and retrieval
- Customer service
- Use of correct grammar, punctuation, and spelling
This position requires the demonstrated ability to:
- Manage multiple, competing priorities
- Establish and maintain effective working relationships with various individuals and groups, including injured employees and fellow staff members
- Communicate effectively both verbally and in writing with all levels of employees and the public
Salary Information:
- Salary (Pay Basis): $3, monthly
Additional Information:
- Employee Status: Regular
- Schedule: Full-time, hours per week
- Travel: Yes, 25% of the time
- Overtime Status: Exempt
- Benefits include 96 hours of accrued vacation and sick leave per year, 20+ holidays annually, career advancement opportunities, free parking, and comprehensive medical insurance for full-time employees with 50% off premium costs for dependents.
- Criminal background checks will be conducted on all final candidates.
- Equal employment opportunity: The organization does not discriminate based on race, color, national origin, gender, religion, age, or disability in employment or service provision.
- Employment preferences are given to former foster youth and individuals with military service, subject to documentation requirements.
Please note that regular attendance is an essential function of every job at the organization.
