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Texas Department of Insurance

The Texas Department of Insurance (TDI) is a state agency responsible for both consumers and the insurance industry. We work to fulfill our legislative mandate to regulate the insurance industry, administer the Texas workers’ compensation system, and promote a healthy insurance marketplace, while also protecting the people and the businesses that are served by insurance. We take our responsibility to Texans seriously and strive for excellent customer service through our professional attitude, competence and efficiency.

Important notice: Read before you apply

Veterans’ preference:

To receive veterans’ preference, applicants must provide at least one of the following documents with their State of Texas Application:

  • a copy of the DD 214, member #4;
  • a statement of compensation from the Veterans Benefits Administration; or
  • a copy of the DD 1300.

Applicable Military Occupational Specialty (MOS) codes are included, but not limited to one of the following: 86M0, 360, YN, 70, 70C

Additional Military Crosswalk information can be accessed at:

http://www.hr.sao.texas.gov/Compensation/MilitaryCrosswalk/MOSC_AccountingAuditingandFinance.pdf  

Veterans: Go to www.texasskillstowork.com for assistance with translating your military work experience and training courses into civilian job terms, qualifications/requirements and skill sets.

Current opportunity: Form Reviewer and Operations Support Specialist

Internal/External Posting-TDI Employees and General Public

The Form Reviewer and Operations Support Specialist performs network adequacy reviews for managed care entities form review; and support work on special project assignments.


This position:

  • performs network adequacy reviews for managed care entities;
  • completes reviews of informational form filings and subsequent filings for workers’ compensation health care networks (WCNs);
  • performs data entry, analysis, and auditing prompt pay reports and penalty payments;
  • performs review of utilization review agent(URAs) and independent review organization (IROs) applications;
  • assists with the creation of and updates to forms and coordinating approval procedures;
  • assists in compiling reports and monthly section dashboard and ad-hoc reports as needed;
  • assist in web posting of the managed care quality assurance office web pages and IRO decisions;
  • performs review, analysis and comments on proposed legislation;
  • assists in creating fiscal notes as needed;
  • participates in legislative implementation processes and documentation;
  • works on special work assignments and projects as needed; and
  • performs other duties as assigned.

Qualifications

Graduation from a four-year college or university with a degree in Insurance or Business Administration, or in a field relative the position. Education and experience relevant to the position may be substituted for one another on a year-for-year basis. 


Additionally, this position requires:

  • two years of experience in the field of health care or experience in insurance with laws and regulations related to health maintenance organizations (HMOs), URAs, IROs, and WCNs.

Preferences for this position include:

  • nursing or law degree; and
  • four years of experience in the field of health care or experience in insurance with laws and regulations related to HMOs, URAs, IROs, and WCNs.

This position requires demonstrated knowledge of:

  • general office practices and administrative procedures;
  • planning and implementation processes;
  • auditing, and/or investigating work; and
  • using a web-content management tool, such as Cascade.

This position requires demonstrated skill in:

  • problem solving, decision making, and planning; and
  • using Microsoft software applications, including Word, Excel, Access, PowerPoint and Outlook.

This position requires the demonstrated ability to:

  • apply critical thinking to analyze and solve work problems;
  • make decisions based on sound reasoning;
  • organize, prioritize, coordinate, and manage multiple tasks and special projects in order to meet established timelines;
  • perform detail oriented assignments with a high degree of accuracy;
  • develop and evaluate policies and procedures, forms, and reports;
  • communicate effectively with consumers, insurance industry, and elected officials; and
  • establish and maintain effective working relationships with department, division and agency staff.

Position details

Opening date:05/21/2018
Functional title:Form Reviewer and Operations Support Specialist
Classification title:Program Specialist II
Status:Internal/External Posting-TDI Employees and General Public
Application deadline:Until Filled
Pay group:B18
Monthly salary: $3,850.00
Annual salary:$46,200.00
Job posting number:18-241
Division:Financial Regulation/Managed Care Quality Assurance
Location:333 Guadalupe Austin, TX 78701
Travel required:5 %

 

For more information, contact:

Last updated: 5/21/2018