SORM | Claims Adjuster | 26-0187

Please paste the following URL into a browser to view the entire job posting in the CAPPS Career Section: may apply to the job directly through the CAPPS Career Section. It is not necessary to apply both through Work In Texas and CAPPS Career SectionGENERAL DESCRIPTIONThe State Office of Risk Management (SORM) is currently seeking a Claims Adjuster who will review and determine compensability on workersand#8217; compensation claims. This entry-level position will manage the intake of claim files interviewing claimants, medical providers, and others to determine the compensability of a claim; with opportunities for career advancement/growth. This person will review, approve or reject claims in accordance with the Texas Workersand#8217; Compensation Act and division of Workersand#8217; Compensation (DWC) Rules and will work under moderate supervision, with limited latitude for the use of independent judgment.The State Office of Risk Managementand#8217;s core missions are customer service oriented. We administer the workersand#8217; compensation program, insurance and risk management programs, and continuity of operations program for other state entities. If youand#8217;re looking for a fulfilling career in public service, we would love to visit with you.As a state employee, you are automatically enrolled in the stateand#8217;s retirement plan and are eligible for additional health insurance benefits.ESSENTIAL POSITION FUNCTIONSResponds to calls and queries from internal and external customersReviews, determines, compensability, and adjusts lost time workersand#8217; compensation in accordance with Texas Workersand#8217; Compensation Act, DWC rules and regulations and internal proceduresUpdates the claim file diary; uses the mainframe system to enter, retrieve and update claim filesInterviews claimants, medical providers, witnesses, and other agency personnel in order to establish compensabilityObtains recorded statements from claimantsAnalyzes data and present ideas effectively both orally and in writingPrepares clear and concise written reports and correspondence to claims, medical consultants and agency personnelPerforms related work as assignedMaintains relevant knowledge necessary to perform essential job functionsAttends work regularly in compliance with agreed-upon work scheduleEnsures security and confidentiality of sensitive and/or protected informationComplies with all agency policies and procedures, including those pertaining to ethics and integrityQualifications: MINIMUM QUALIFICATIONSEducation: Graduation from high school or equivalentExperience: One year of full-time experience working in the following (or closely related) fields: general office, complex clerical, and secretarial experience. Experience and education may be a substitute for one anotherKnowledge of medical terminologyKnowledge of Texas Workersand#8217; Compensation law and claimsSkill in handling multiple tasks, prioritizing, and meeting deadlinesSkill in effective oral and written communication {writing sample will be administered at the time of interview}Skill in exercising sound judgment and effective decision makingAbility to receive and respond positively to constructive feedbackAbility to work cooperatively with others in a professional office environmentAbility to obtain and maintain an adjusterand#8217;s licenseAbility to provide excellent customer serviceAbility to arrange for personal transportation for business-related travelAbility to work more than 40 hours as needed and in compliance with the FLSAAbility to lift and relocate 30 lbs.Ability to travel (including overnight travel) up to 5%PREFERRED QUALIFICATIONSEducation: Bachelor's degree from an accredited college or universityKnowledge: Advanced knowledge of medical and pharmaceutical terminologyKnowledge: Advanced knowledge of generally accepted medical roceduresCertifications: Associate in Claims or other related insurance certificationTO APPLY All applications for employment with the State Office of Risk Management must be submitted electronically through A State of Texas application in WorkInTexas (WIT) must be completed to be considered OR Submit a State of Texas Application for Employment to: Attn: Elaina Middleton, State Office of Risk Management, P.O. Box 13777, Austin, TX 78711-3777. Military Crosswalk information can be accessed at SORM IS AN EQUAL OPPORTUNITY EMPLOYER

Created: 2025-12-25