Manage the Workers' Compensation Self-Insurance program, ensuring adherence to Texas Workers' Compensation Laws and internal protocols.
Manage the third-party administrator (TPA) for our Workers' Compensation program to ensure compliance with Workers' Compensation laws, district agreements, and internal procedures.
Regularly audit the claim files of TPA to verify compliance and determine if claim response and reporting times adhere to department internal procedures
Manage workers' compensation claim payments processed in-house and by the TPA and approve claim settlements.
Annually contribute to the preparation of the workers' compensation program budget and provide necessary data for the actuarial analysis conducted by the actuarial consulting firms and address any complaints or inquiries from employees regarding Workers' Compensation benefits.
Collaborate with the TPA and legal counsel for litigated workers' compensation cases.
Evaluate the performance, utilization, and effectiveness of all vendors involved in the workers' compensation program.
Stay informed and monitor all proposed legislation that may affect workers' compensation claims
Manage and adjust procedures to ensure full compliance with the Texas Workers' Compensation Law at all times.
Develop and maintain close communication with medical providers providing services for injured employees and serve as the liaison between medical providers, injured employees, and TPA
Develop and produce reports upon request from the District's Risk Management Information System.
Visit sites of Third-Party Administrators and 504 Health Care Program facilities
Develop, implement, and manage cost containment programs and claims adjusting systems to respond to all claim issues
Develop, implement, and monitor workers' compensation claim reporting forms, procedures and activities
Monitor returned checks to ensure claimants receive payments timely and collect subrogation checks to deposit in the appropriate line code.
Manage records of workplace injuries and illnesses through the Fiscal Year for U. S. Department of Labor Bureau of Labor Statistics
Manage information submitted through electronic filings to the Division of Workers' Compensation
Manage the Return-to-Work program
Develop and manage Request of Proposals (RFPs) for the workers' compensation program.
Responsible for interviewing, hiring, and training employees; planning, assigning, and managing work; appraising performance.
Participate with the Benefits Review Committee.
Qualifications
Bachelor's degree from an accredited university required; concentration in business or public administration with accounting, insurance, or risk management emphasis preferred
Five years' directly related experience; prior supervisory experience preferred
Demonstrated knowledge of Texas workers' compensation code, medical fee guidelines, and electronic data interchange
Demonstrated knowledge of principles, trends, methods, and procedures pertaining to risk management, risk insurance, accident prevention and loss control programs, insurance regulations, and self-funded programs
Demonstrated knowledge of laws pertaining to work related injury or illness, school district liability, and public safety
Demonstrated ability to interpret policy, procedures, and data
Demonstrated ability to respond to common inquiries or complaints from employees, board members or members of the general public
Demonstrated effective interpersonal skills to interact with all levels of employees, staff members and the general public
Demonstrated ability to coordinate multiple projects and assignments; high degree of flexibility required