Job Title: Early Assistance Advocate for Injured Employees (Ombudsman I)
Job Responsibilities:
An Early Assistance Advocate (Ombudsman I) is responsible for working closely with senior Ombudsmen to advocate, assist, and educate injured employees in Texas regarding workers' compensation claims. The primary responsibilities include:
- Utilizing early intervention strategies to assist injured employees before hearings.
- Providing one-on-one assistance to injured employees.
- Answering questions and reviewing claims for medical and income benefits.
- Studying and analyzing the case background for each claim.
- Gathering and evaluating information, including medical records and letters from doctors.
- 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 related laws/rules.
- Advocating for the expedient resolution of claims by assembling necessary evidence for insurance carrier determinations or benefit proceedings.
- Contacting insurance carriers and medical providers to identify and resolve disputes.
- Assisting with referrals to social services and other state agencies.
- Providing assistance in filing claims and obtaining supporting documentation from doctors.
- Routinely contacting injured employees to provide updates and discuss upcoming events.
- Documenting customer contact in the computer system.
- Answering general customer service questions.
- Performing additional 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. Education and relevant experience may be substituted for one another on a year-for-year basis.
Required Knowledge, Skills, and Abilities:
- Proficiency in Microsoft Word, Excel, and Outlook.
- Skills in assisting the public, conflict resolution, problem-solving, report writing, records maintenance, interpreting and explaining laws and regulations, data entry and retrieval, customer service, and the use of correct grammar, punctuation, and spelling.
- Ability to manage multiple, competing priorities.
- Ability to establish and maintain effective working relationships with a variety of individuals and groups, including injured employees and fellow staff members.
- Effective communication skills, both verbally and in writing, with all levels of employees and the public.
Salary Information:
- Salary Admin Plan: B
- Grade: 17
- Salary (Pay Basis): $3, per month
Additional Information:
- The position is full-time with a standard 40-hour workweek.
- Travel is required, up to 25% of the time.
- The position is exempt from overtime.
- The job includes a hybrid work schedule if applicable, accrued vacation and sick leave, numerous holidays, career advancement opportunities, free parking, and comprehensive medical insurance benefits for full-time employees.
Application Process:
- Interested candidates should apply through Work in Texas, ensuring all applications contain complete job histories and supplemental questions are completed.
- Criminal background checks will be conducted on all final candidates.
- Equal employment opportunity is provided, with preferences given to former foster youth and military applicants as per state guidelines.
Legal and Employment Preferences:
- Former Foster Youth Preference: Preference is given to individuals under the permanent managing conservatorship of the Department of Family and Protective Services before their 18th birthday.
- Military Employment Preference: Preference is given to military veterans, their spouses, orphans, and surviving spouses as per Senate Bill 1376, 88th Legislature, Regular Session, Section . Required documentation must be submitted with the application.
For more information about working with the Office of Injured Employee Counsel, applicants can visit the provided link to learn more about the organization and available opportunities.
