GENERAL DESCRIPTION
Work includes active participation in establishing Claims Operations Department goals and objectives; developing department guidelines, procedures, policies, rules, and regulations; developing schedules, priorities, and standards for achieving department goals; evaluating department activities; and coordinating department activities. Plans, assigns, and supervises the work of others.

ESSENTIAL POSITION FUNCTIONS

• Oversees the work of assigned unit within Claims Operations Department
• Participates in the preparation of program management and productivity reports and studies
• Confers with staff on department issues and problems to identify and implement solutions
• Plans, implements, coordinates, monitors, and evaluates programs
• Participates in establishes department goals and objectives; and develops and approves schedules, priorities, and standards for achieving goals
• Participates in the development of department goals and objectives evaluation activities
• Provides technical assistance in a department area
• Plans, assigns, and supervises the work of others
• Communicates openly and honestly with colleagues and customers
• Takes personal responsibility for the quality and content of assigned units’ work product
• Prioritizes unit and individual workload to ensure deadlines are met and productivity maximized
• Ensure equal collaboration and contribution among unit and claims department
• Development of claims adjusters, explaining claims processes, deadlines and overall claims handling in an understandable manner.
• Maintain and retain claims staff, along with working to keep team morale at a positive state
• Review claims from adjusters on the team to ensure quality of claims handling.
• Performs related work as assigned
• Maintains relevant knowledge necessary to perform essential job functions
• Attends work regularly in compliance with agreed-upon work schedule
• Ensures security and confidentiality of sensitive and/or protected information
• Complies with all agency policies and procedures, including those pertaining to ethics and integrity

MINIMUM QUALIFICATIONS

• Education: Graduation from high school or equivalent
• Experience: Five years full-time reviewing, adjusting, or processing workers’ compensation claims experience
• Licensed to adjuster workers’ compensation claims in Texas {License will be verified pre-employment}
• Knowledge of Division of Workers’ Compensation appeals process
• Knowledge of medical terminology
• Knowledge of Texas Workers’ Compensation law and claims administration
• Skill in working under pressure and meeting deadlines
• Skill in working effectively with a diverse of customers
• Skill in handling multiple tasks, prioritizing, and meeting deadlines
• Skill in effective oral and written communication [Writing sample required at time of application and administered at the time of interview]
• Ability to be an independent worker within a team environment
• Skill in exercising sound judgment and effective decision making
• Ability to make timely, informed decisions that take into account the facts, goals, constraints, and risks
• Ability to interpret and appropriately apply complex rulings regarding Texas Workers’ Compensation law and claims administration
• Ability to receive and respond positively to constructive feedback
• Ability to work cooperatively with others in a professional office environment
• Ability to provide excellent customer service
• Ability to provide a positive work environment for claims staff
• Ability to complete assignments with attention to detail and accuracy
• Ability to arrange for personal transportation for business-related travel
• Ability to work more than 40 hours as needed and in compliance with the FLSA
• Ability to lift and relocate 30 lbs.
• Ability to travel (including overnight travel) up to 5%

PREFERRED QUALIFICATIONS

• Education: Graduation from an accredited four-year college or university
• Management experience
• Advanced knowledge of medical and pharmaceutical terminology
• Advanced knowledge of general accepted medical procedures
• Associate in Claims or other related insurance certification

TO APPLY
All applications for employment with the State Office of Risk Management must be submitted electronically through www.WorkInTexas.com. A State of Texas application in WorkInTexas (WIT) must be completed to be considered OR Submit a State of Texas Application for Employment to: Attn: Elaina Middleton, State Office of Risk Management, P.O. Box 13777, Austin, TX 78711-3777. Military Crosswalk information can be accessed at

https://hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_ProgramManagement.pdf

THE SORM IS AN EQUAL OPPORTUNITY EMPLOYER