TDI-Program Specialist V (Health Care Provider & Return to Work Outreach Specialist)

Do you have a passion for public state service and enjoy making a difference? Don’t miss out on this opportunity. The Texas Department of Insurance, Division of Workers’ Compensation (DWC) is hiring! DWC administers and operates the Texas workers’ compensation system. DWC regulates the workers’ compensation system, settles disputes, provides customer service, promotes workplace safety, and ensures compliance with state laws. DWC is located in the Capitol Complex, in the Barbara Jordan Building at 1601 Congress Avenue in Austin, near the Texas Capitol. 

Benefits of working at TDI:

·         Flexible work schedules.

·         Work-life-balance.

·         96 hours of accrued vacation a year.

·         96 hours of accrued sick leave a year.

·         20+ holidays every year.

·         Career advancement opportunities.

·         Free parking.

·         401(k) and 457 Programs.

·         State of Texas retirement plan with a lifetime annuity through the Employee Retirement System of Texas (ERS).

·         Free comprehensive medical insurance for full-time employees and 50% off premium costs for dependents (state pays the other 50%). 

·         Optional benefits like dental, vision, life insurance, and many more.

·         Qualified employer for the Federal Public Service Loan Forgiveness Program. 

Before you apply:

Learn about our selection process, our military employment preference, licensing, and credential requirements. 

Program Specialist V (Health Care Provider and Return to Work Outreach Specialist)

The Health Care Provider (HCP) and Return to Work (RTW) Outreach Specialist reports to the HCP & RTW Outreach and Education Director (Outreach Director).  The position performs advanced (senior-level) consultative services, customer service, administrative support, and technical assistance work. Work involves receiving and responding to inquiries for information about the Texas workers’ compensation system and providing outreach to HCPs, employers, and other system participants. Work involves planning, developing, presenting, supporting webinar logistics and implementing educational material for the HCP outreach and assists with RTW outreach. Works under limited supervision, with considerable latitude for the use of initiative and independent judgement.

This position:

·         Performs an array of technical training, research, planning, and administrative activities related to the HCP and RTW Outreach program. Including but not limited to assisting callers, responding to emails from external stakeholders with questions about the Labor Code and administrative rules, running queries to find an HCP, assisting with claims and customer service on certain claims, and entering information and summaries of calls and emails into a database. 

·         Performs comprehensive reviews of literature, statutes, rules, medical billing, coding, or policies; and prepares administrative reports, studies, and specialized research projects. Including but not limited to returning and tracking medical bills that were misdirected to DWC; and collecting, tracking, and reporting performance measure data for the Outreach program.

·         Collaborates with program staff in determining trends and resolving technical problems affecting HCPs and other system participants. Provides one-on-one education about dispute processes to HCPs referred to CompConnection from Audits & Investigations.

·         Assist in the management of the Outreach initiatives and activities.  Including, but not limited to being a presenter for HCP Outreach, including preparing the presentation material, slides, and presenter note,s and may assist in RTW presentations. Provides administrative and webinar logistical support for the Outreach program area.

·         Collaborates in the planning, development, implementation, and analysis for future HCP outreach and assists with RTW initiatives and activities. Works with the Communications program on marketing strategies and materials.

·         Markets program activities such as webinars and on-demand videos to HCPs and other system participants, including attending industry conferences, staffing exhibit booths to encourage and increase participation in the workers’ compensation system, and providing outreach to the health care providers and other system participants.

·         Performs other duties as assigned.

This position requires: 

·         Graduation from an accredited four-year college or university with a degree in Communications, Business, Health Care Administration, or a field relevant to the assignment.

·         Additionally, this position requires 5 years of experience in workers’ compensation, customer service, return to work, medical billing, coding, or medical reimbursement.

·         Regular work attendance.

·         Education and experience relevant to position requirements may be substituted for one another on a year-for-year basis. 

Additional job details:

·         The interview will include a logic and writing test.

Preferences for this position include:

·         Certified Professional Coder

This position requires demonstrated knowledge of:

·         State laws, rules, procedures, and regulations relevant to job requirements.

·         Public administration and management techniques.

·         Business or program terminology, spelling, punctuation, grammar, typing formats, word processing techniques, software, and procedures.

·         Strong organizational and project management skills.

·         CMS payment policies relating to coding, billing, and reporting. 

·         Medical terminology, reimbursement, and coding laws governing health care administration. 

·         Research techniques.

·         Training and marketing techniques.

This position requires demonstrated skill in:

·         Problem-solving and critical thinking.

·         Using Microsoft Office software applications, including Word, Excel, Outlook, and SharePoint.

·         Using personal computers sufficient to enter and extract data from related systems and programs such as Centralized Accounting Payroll and Personnel (CAPPS) and other systems required to perform the job.

·         Identifying measures or indicators of program performance.

·         Strong organizational and project management skills.

·         Training and educating the public.

·         Maintaining professional conduct with external and internal customers/clients. 

This position requires the demonstrated ability to:

·         Communicate and work effectively with a wide range of people with varied skills, knowledge, and backgrounds.

·         Maintain the confidentiality of sensitive information.

·         Analyze and solve work-related problems and work independently on a variety of administrative work and technical assignments.

·         Manage and coordinate multiple tasks and priorities to meet necessary deadlines.

·         Work both independently and as a team player.

·         Apply critical thinking to analyze systems and procedures.

·         Gather, assemble, correlate, and analyze facts.

·         Prepare reports in a timely manner.

·         Exercise and apply sound judgment when making decisions.

·         Develop, evaluate, and interpret policies and procedures.

Military Employment Preference

Get help translating your military work experience and training courses into civilian job terms, qualifications/requirements, and skill sets. Redact personal or sensitive information from all attachments.

To receive a military employment preference, you must submit the following documents, as applicable, with your application. See How to Apply – Military Employment Preference.

Applicable Military Occupational Specialty (MOS) codes are included, but not limited to one of the following:

OS, OSS, PERS, 641X

Click or copy and paste the following link into your browser to access Military Crosswalk information:

http://www.hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_ProgramManagement.pdf

How to apply:

All applications must contain complete job histories, including job title, dates of employment, name of employer, manager’s name and phone number, and a description of duties performed. We may reject applications that do not include all the required information. Resumes do not substitute for this required information.

Submitted through Work in Texas:

Work in Texas (WIT) applicants must complete supplemental questions to be considered for the position. To complete supplemental questions, go to CAPPS Career Center to register or log in and access your profile.