Medical Only Adjuster II

Why Texas Association of School Boards (TASB)

We come from humble beginnings — picture a one-person organization created in 1949 to advocate for excellence in public education on behalf of Texas school board members. Flash forward to today, and we have over 500 employees working together to provide 1,024 school districts with purposeful resources so they can focus on what matters most — excellent and equitable education for all 5.4 million Texas students. 

As TASBeans (our internal name for employees), we feel privileged to work alongside talented team-members who are passionate about education and enjoy learning from new and different perspectives.  We believe what makes our organization highly successful is the rich diversity our employees collectively bring to TASB with different backgrounds, skillsets, cultures and ethnicities, gender identities, interests, abilities, and work styles. And our passion for education and learning doesn’t end there. Our culture has always encouraged employees to grow and become their best selves both professionally and personally through a variety of innovative and collaborative development opportunities. You’re likely beginning to see why we’ve been regularly named by Austin Business Journal as a Top Ten Best Places to Work! 

TASB offers competitive pay, rich benefits (including retirement matching of 2:1 up to 5% after one year. This means that if you contribute 5% to the plan, TASB will contribute 10%), onsite daycare, onsite gym, wellness program, tuition reimbursement, remote work options, flexible schedules, and more. 

Every role at TASB thoughtfully complements our mission and the educational impact being made in communities across Texas. If you consider your work exceptional and want to help drive our mission forward, keep reading!

About You

Medical Only Adjuster's purpose is to investigate and evaluate all assigned claims and pay any benefits due in a timely manner, per Texas WC statutes and guidelines. In addition, our primary purpose is to provide quality service to our member districts and all injured employees. This position is hybrid requiring the successful candidate to work at least two days a week at our North Austin headquarters. 

A Typical Day 

• Investigate and evaluate all assigned medical only claims in a timely manner, per departmental guidelines.
• Assist member districts with general claims questions/concerns.
• Maintain contact with customers, either oral or written, to ensure proper communication of actions taken on all assigned claims.
• Maintain a working diary on all assigned claims, per departmental guidelines.
• Comply with all filing requirements, as mandated by applicable governing agency(s).

How You’ll Make an Impact

• Maintain proper reserves on all assigned claims under the direction of Claims Manager, and/or Department Director.
• Determine coverage and/or compensability on all assigned claims, with direct supervision.
• Diary and monitor claims assigned to independent vendors, when applicable and with supervision.
• Handle all correspondence in a timely manner, per department guidelines.
• Become familiar with the claims software and imaging system, as adopted by TASBRMF, within three months of hire/promotion.
• Attend team and departmental meetings as requested.
• Request and/or participate in claims committee meetings.
• Answer general claims questions and have a working knowledge of accepted claims handling procedures, within six months of hire.
• Travel as required.
• Review and apply relevant court decisions, when applicable.
• Possess working knowledge of the Best Practices Guidelines (BPG), within six months of hire.
• Complete time sheets, travel requests, expense forms, etc. when applicable and per departmental guidelines.
• Maintain current Texas adjuster license 03 or 08.
• Perform other duties as assigned by the Claims Manager, Department Director, Division Director, and/or the Associate Executive Director for RMF of TASB, Inc.

Skills For Success

Education and Experience: 

• High School diploma or equivalent required. Bachelor’s Degree or some college preferred.
• Type 03 or 08 Texas adjuster license required within one year of hire. Type 08 preferred.
• At least 1 year experience with claims handling experience or related job experience required. 

Knowledge, Skills, and Abilities: 

• Ability to interact with extern