Job Title:
Early Assistance Advocate for Injured Employees (Ombudsman I) – Statewide
Job Responsibilities:
An Early Assistance Advocate (Ombudsman I) is tasked with working alongside senior Ombudsmen to provide advocacy, assistance, and education to injured employees in Texas. The role involves:
- Utilizing early intervention strategies to assist injured employees before hearings.
- Assisting injured employees one-on-one and addressing their questions.
- Reviewing claims for medical and income benefits 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 and tracking claim status.
- Educating injured employees about the workers’ compensation dispute process and relevant 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 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:
- .
- 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.
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:
- Travel required: 25%.
- The position is classified as Ombudsman I – Exempt under FLSA.
- 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% premium costs for dependents covered by the state.
Equal employment opportunity:
- The organization does not discriminate based on race, color, national origin, gender, religion, age, or disability in employment or the provision of services. Requests for reasonable accommodation during the application process should be directed to the designated email.
Employment Preferences:
- Former Foster Youth Preference: Individuals under the permanent managing conservatorship of the Department of Family and Protective Services before their 18th birthday are entitled to employment preference with the state agency over other candidates without greater qualifications.
- Military employment preference: State agencies must give preference to veterans and certain family members under Senate Bill 1376, 88th Legislature, Regular Session, Section . Required documents for military preference must be submitted with the application, including DD Form 214 and other applicable documentation.
Note:
- Criminal background checks will be conducted on all final candidates.
- Regular attendance is an essential function of every job at the organization.
- All applications must contain complete job histories, including job title, dates of employment, name of employer, manager’s name, and a description of duties performed. Resumes do not replace this required information.
- Applications are submitted through Work in Texas, and supplemental questions must be completed to be considered for the posting.
- Military Occupational Specialty (MOS) codes applicable to the role include 27A, 250X, LGL10, 4421, 4402, 4430, 51JX, 92J0.
