TRISTAR Insurance Group
TRISTAR Insurance Group
TRISTAR Insurance Group — жұмыс берушілерге, сақтандыру компанияларына және мемлекеттік ұйымдарға сақтандыруды әкімшілендіру мен тәуекелдерді басқару қызметтерін ұсынатын ұлттық деңгейдегі үшінші тарап әкімшісі. Компания мүлік пен жазатайым оқиғалардан сақтандыру бағдарламаларын, еңбекке байланысты өтемақыны, жалпы және автокөлік жауапкершілігін, басқарылатын медициналық көмекті, еңбек демалысы мен мүгедектікті басқаруды, қызметкерлердің топтық жеңілдіктерін әкімшілендіруді және жұмыс орнындағы қауіпсіздікті қолдайды. Басқарылатын медициналық көмек бағытындағы мүмкіндіктеріне шоттарды тексеру, жағдайды басқару, медициналық қызметті пайдалану тиімділігін тексеру, мейіргерлік триаж және дәріхана жеңілдіктерін басқару кіреді. TRISTAR технологияға негізделген операцияларын жекелендірілген қызмет көрсету тәсілімен ұштастырып, клиенттеріне күрделі сақтандыру және қызметкерлерге арналған жеңілдіктер қажеттіліктері аясында тәуекелдерді басқаруға көмектеседі.

Workers' Compensation Claims Examiner III – Hybrid Texas

Handle complex Texas workers’ compensation indemnity claims from initial review through final resolution. The role covers exposure assessment, litigation oversight, reserves, settlements, and defense strategy.

Сипаттама

  • Manage a portfolio of approximately 125–150 highly complex Texas workers’ compensation indemnity claims from intake through resolution.
  • Assess challenging compensability, medical, disability, and litigation issues.
  • Create practical strategies for resolving complex claims.
  • Set and revise reserves and approve payments and settlements within delegated authority.
  • Manage defense counsel while reviewing litigation strategy, major legal developments, and settlement proposals.
  • Produce detailed, captioned reports on claim status, exposure, reserves, litigation strategy, and recommended outcomes.
  • Refer matters beyond delegated authority or requiring management review.
  • Offer technical support to less experienced Claims Examiners without direct supervisory responsibility.

Талаптар

  • High school diploma or GED.
  • At least three years of related experience.
  • Advanced knowledge of Texas workers’ compensation law, regulations, and claims-handling requirements.
  • Ability to independently handle highly complex, litigated, and high-exposure claims with limited supervision.
  • Ability to assess exposure, formulate resolution strategies, and apply sound judgment within delegated authority.
  • State-required certification or license.
  • Ability to meet the role’s mental and physical demands, including sedentary work, fingering, grasping, speaking, hearing, and repetitive wrist, hand, and finger movements.

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