Texas Workers' Compensation / Non-Subscriber Adjuster

Introduction to Davies North America

Imagine being part of a team that’s not just shaping the future but actively driving it. At Davies North America, we’re at the forefront of innovation and excellence, blending cutting-edge technology with top-tier professional services. As a vital part of the global Davies Group, we help businesses navigate risk, optimize operations, and spearhead transformation in the insurance and regulated sectors. Our commitment to excellence has positioned us as a leader in our field, and we’re now seeking a highly skilled and dedicated Texas Workers' Compensation / Non-Subscriber Adjuster to join our team.

About the Role

We're on the lookout for a talented and experienced Texas Workers’ Compensation / Non-Subscriber Adjuster to investigate and manage Workers' Compensation and Texas Non-Subscriber claims for self-insured political subdivisions and Texas Non-Subscriber employers. As a key member of our team, you will play a critical role in ensuring that claims are handled efficiently, effectively, and in accordance with relevant laws and regulations. This is a full-time, home-based position that offers the opportunity to work remotely and occasionally travel to clients for quarterly claims review meetings.

Key Responsibilities

• Conduct initial three-point contact claims investigation to determine compensability
• Pay benefits in accordance with the WC Statute and/or employers’ ERISA plan document
• Work in conjunction with the client and business partners to keep them informed as claims develop
• Maintain contact with the injured employee, medical provider, and employer to facilitate return to work
• Monitor ongoing medical reports and treatment plans to manage the claim and set reserves accordingly
• Review, approve, and manage medical treatment
• Review and approve medical bills for adjudication in the Mitchell bill CEP system
• Support claim positions before legal proceedings by producing information, reports, and other documents as supportive evidence

Your Expertise, Skills, and Abilities

To be successful in this role, you will need to possess a strong foundation in Texas Workers' Compensation and Non-Subscriber claims adjustment, as well as excellent communication, organizational, and analytical skills. Specifically, we’re looking for:

• 5 years of experience adjusting Texas Workers’ Compensation and Non-Subscriber claims
• Texas Workers’ Compensation Adjuster’s license
• Technical Workers’ Compensation claims and medical terminology knowledge
• Excellent verbal and written communication skills
• Proficient with the use of computers and Microsoft Office Suite
• Exceptional organization and time management skills
• Demonstrated ability to gather, analyze, and interpret information

Essential Qualifications

In addition to the skills and experience listed above, the ideal candidate will also possess:

• A strong understanding of Texas Workers' Compensation laws and regulations
• Experience working with self-insured political subdivisions and Texas Non-Subscriber employers
• Knowledge of medical terminology and procedures
• Ability to work independently and as part of a team
• Strong problem-solving and analytical skills

Preferred Qualifications

While not required, the following qualifications are preferred:

• Certification as a Workers' Compensation Claims Adjuster
• Experience working with claims management software
• Knowledge of ERISA plan documents and procedures
• Bachelor’s degree in a related field

Career Growth Opportunities and Learning Benefits

• Ongoing training and professional development opportunities
• Mentorship and coaching from experienced professionals
• Opportunities for advancement and career growth
• A collaborative and supportive work environment

Work Environment and Company Culture

We pride ourselves on fostering a diverse and inclusive workplace that embraces a wide range of perspectives and experiences. Our company culture is built on the values of innovation, excellence, and teamwork, and we’re committed to creating an environment where all employees feel valued, respected, and empowered to succeed.

Compensation, Perks, and Benefits

In addition to a competitive salary, we offer a comprehensive benefits package that includes:

• Medical, dental, and vision plans to ensure your health and that of your family
• A 401k plan with employer matching to help you build a secure financial future
• Generous time-off policies, including Discretionary Time Off and Paid Time Off (PTO)
• Paid holidays
• Life insurance and both short-term and long-term disability plans

Diversity and Inclusion

We believe that diversity of thought is essential for innovation and creativity, and we actively promote an environment where all voices are valued and heard. Our commitment to diversity and inclusion is reflected in our hiring practices, employee development programs, and community outreach initiatives.

Conclusion

If you’re a motivated and experienced claims adjuster looking for a new challenge, we encourage you to apply for this exciting opportunity. As a Texas Workers' Compensation / Non-Subscriber Adjuster at Davies North America, you will be part of a dynamic team that is shaping the future of the insurance and regulated sectors. Don’t miss out on this chance to join our team and take your career to the next level. Apply now and let’s discuss how you can become a vital part of our success story.