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Claims Analyst

Job Description

TITLE: Claims Analyst

JOB CODE: 9596

EFFECTIVE DATE:

FLSA STATUS: E

EEO6 CODE: 3 = Professional/Non-faculty

GRADE: Pay Grade 8

PAY PLAN: Annually
minimum 28,440.00
midpoint 36,120.00
maximum 43,800.00

PURPOSE: To manage claims in a thorough and cost-effective manner to ensure proper care to injured employees.

DUTIES AND RESPONSIBILITIES: Manage WCI claims in accordance with UT System policy and applicable WC laws and TWCC rules as it relates to employer responsibility. Represent UTA at administrative hearings. Review and research claims, if required, prepare documentation and present UTA's employer position before TWCC. Respond to inquiries from injured employees, department supervisors, health care providers and UT Systems Adjusters. Provide WCI training to UTA supervisors, employees and WC support staff. Process medical for reimbursement. Compile WCI statistics of specific injury categories for TWCC surveys, as required. Serve as liaison between treating physician, department supervisor, injured employee, and Adjuster's office to seek proactive approaches for returning "lost time" employees to work. Effectively handle the WCI, ADA and FMLA overlap as it relates to the injured employee and their rights. Work with department supervisors regarding the sensitive handling/termination of insubordinate employees that have an active WC1 claim.

REPORTING RELATIONSHIPS: REPORTS TO: Work methods or approaches to work problems usually are determined by the incumbent. Minimal to general support from Director and/or Administrative Assistant. SUPERVISION: N/A SUPERVISION-OTHER: General and specific instructions given to clerical staff.

REQUIRED EDUCATION: $education

REQUIRED EDUCATION-OTHER: High School graduation or equivalent.

REQUIRED EXPERIENCE / COMPETENCIES-OTHER: REQUIRED EXPERIENCES/COMPETENCIES: Minimum of 3 years worker's compensation experience. Type 03 Texas Adjuster License or eligibility for licensure within 3 months of beginning date of employment. OTHER REQUIREMENTS: Personal computer and standard office machines. Accuracy in all phases of work performed. Specific job requirements or physical location of some positions allocated to this classification, may render the position security/sensitive, and thereby subject to the provisions of Section 51.215 Texas Education Code.