Workers Compensation Adjuster (TX)
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Job Location:
Irving, TX - USA
Monthly Salary:
$ 75000 - 82000
Posted on:
15 hours ago
Vacancies:
1 Vacancy
Job Summary
Position Overview
The Workers Compensation Claims Examiner is responsible for managing and resolving Texas workers compensation claims while ensuring compliance with the Texas Department of InsuranceDivision of Workers Compensation (TDI-DWC). This hybrid role is based out of the Irving TX office and offers a blend of in-office collaboration and remote work flexibility. The examiner handles investigations benefit administration communication with stakeholders and settlement strategies to drive timely fair claim resolution.
Key Responsibilities
Claims Management
Manage a caseload of Texas WC claims from initial report through resolution.
Conduct prompt thorough investigations including recorded statements and employer interviews.
Analyze medical records wage reports and compensability factors to determine appropriate benefits.
Monitor treatment plans and coordinate with providers to ensure medically necessary care.
Regulatory & Compliance
Follow all requirements under the Texas Labor Code TDI-DWC rules and strict timeline mandates.
Issue timely notices benefit payments PLN forms and other required documentation.
Maintain accurate claim files and ensure compliance with internal and external audits.
Communication & Coordination
Collaborate closely with employers injured workers medical providers attorneys and nurse case managers.
Communicate claim status and next steps clearly and professionally.
Support employers with return-to-work planning including modified duty options.
Litigation & Legal Support
Work with defense counsel on disputed claims benefit review conferences (BRC) and contested case hearings (CCH).
Prepare litigation summaries evaluations and recommendations for settlement authority.
Attend hearings (in person or virtual) when needed.
Financial & Settlement Management
Set and maintain accurate reserves based on exposure and medical progression.
Evaluate settlement opportunities and negotiate within designated authority.
Identify fraud indicators and pursue subrogation when appropriate.
Qualifications
Experience handling Texas Workers Compensation claims required.
Strong knowledge of TDI-DWC rules forms deadlines and dispute resolution processes.
Excellent communication investigative and negotiation skills.
Ability to work efficiently in a hybrid environment based out of Irving TX.
Certifications such as AIC ARM or WCCP preferred but not required.
Key Skills
- Accounts Administration
- Customer Service
- Advocacy
- ABAP
- Electronics
- Bakery
About Company
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