Job Title: Early Assistance Advocate for Injured Employees (Ombudsman I)
Job Responsibilities:
An Early Assistance Advocate, also known as Ombudsman I, operates under the umbrella of the **Members Only** (OIEC) and works in collaboration with senior Ombudsmen. The primary responsibilities include advocating, assisting, and educating injured employees in Texas, particularly before hearings. The role involves:
- Assisting injured employees on a one-on-one basis
- Answering questions and clarifying doubts for the injured employees
- Reviewing claims related to medical and income benefits
- Analyzing case backgrounds and gathering necessary information, including medical records and doctors' letters
- Preparing and responding to requests for Designated Doctor examinations
- Evaluating and implementing strategies for early claim resolution
- Reporting and referring complaints
- Tracking and providing claim status updates
- Educating injured employees about the workers’ compensation dispute process and pertinent laws/rules
- Advocating for prompt claim resolution by assembling necessary evidence for insurance carrier determinations or benefit proceedings
- Contacting insurance carriers and medical providers to resolve disputes
- Assisting with referrals to social services and other state agencies
- Providing assistance in filing claims and obtaining supporting documentation from doctors
- Regularly 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 assigned duties
Education and Experience Information:
The position requires a graduation from an accredited four-year college or university. Additionally, candidates must have at least one year of experience in claims management, insurance, casework, healthcare, social work, law office (paralegal/legal assistant), or workers’ compensation. Education and relevant experience can be substituted for each other on a year-for-year basis.
The position also requires knowledge of Microsoft Word, Excel, and Outlook. Candidates must demonstrate skills in public assistance, conflict resolution, problem-solving, report writing, records maintenance, interpreting and explaining laws and regulations, data entry and retrieval, customer service, and the correct use of grammar, punctuation, and spelling.
Candidates must demonstrate the ability to manage multiple, competing priorities, establish and maintain effective working relationships with various individuals and groups, and communicate effectively both verbally and in writing with all levels of employees and the public.
Salary Information:
The salary for this position is based on a monthly pay basis, set at $3,.
Additional Information:
This position is full-time, with a standard 40-hour work week. It requires travel up to 25% of the time and is classified under the state job code 3660, Salary Admin Plan B, Grade 17. The position is exempt from overtime status and offers a range of benefits, including 96 hours of accrued vacation and sick leave per year, over 20 holidays annually, career advancement opportunities, free parking, and comprehensive medical insurance for full-time employees.
The **Members Only** offers preferences in employment for former foster youth and individuals with military backgrounds, provided relevant documentation is submitted with their application. The agency also emphasizes the importance of regular attendance for all jobs within the organization.
Applicants are required to submit complete job histories, including job title, dates of employment, employer's name, manager’s name, and phone number. Criminal background checks will be conducted on all final candidates. The organization adheres to equal employment opportunity principles and does not discriminate based on race, color, national origin, gender, religion, age, or disability.
For more information and to apply, candidates are encouraged to visit the specified links for job applications and military crosswalk information.
