Analyze medical data (Claim, Payee, Provider, etc.) on medical billing forms to ensure accurate results within the medical billing process including associated internal and vendor platforms. Proactively identify system and/or bill review issues and provide feedback to your lead or supervisor. Add or edit Provider and Claim information as appropriate. Examines, investigates, analyzes, and reports on all aspects of the medical benefits provided to injured workers to ensure the medical benefits provided to injured workers are appropriate, timely, cost-effective, and in compliance with state statutes and regulations. Identifies performance and compliance issues; develops recommendations designed to enhance external and internal compliance, efficiency, and effectiveness; and provides advice on implementation. Provide customer service to internal and external customers in a professional and respectful manner. Addresses day-to-day inquiries related to medical bills. Meets daily, monthly, quarterly, and annual performance expectations and statutory deadlines related to payment and audit of medical benefits. Represents the interests of the agency in a professional, courteous, and respectful manner. Performs related work as assigned. Maintains relevant knowledge necessary to perform essential job functions. Attends work regularly in compliance with agency leave policy and agreed-upon work schedule Ensures security and confidentiality of sensitive and/or protected information. Complies with all agency policies and procedures, including those pertaining to ethics and integrity.
Learn more about this opportunity by reading the full job description for the Medical Clean Bill Analyst (Claims Examiner I PDF) position and apply below.
The State Office of Risk Management is a unique state agency with an environment of creativity and collaboration. Our employees appreciate the warm atmosphere, mutual respect, progressive approach, engagement, and genuine community that comes from truly caring about each other and what we can do together. We don’t do silos, and your voice and happiness is as important as your skill. We take pride in our mission, our colleagues, and our belonging.
Advantages of working with SORM:
- Casual dress code
- Open and accepting environment
- Wellness and employee engagement activities
- Much more.
Advantages of working for the State:
- State Medical/dental/vision benefits
- Free downtown parking
- Employee Assistance Program from legal services to mental health
- Transit discounts
- State discounts are offered at many stores, hotels, cell phone service providers, and more!
The Texas State Office of Risk Management is administratively attached to the Office of the Attorney General and is governed by a five-member Board. The Office is charged by law to administer insurance services obtained by Texas state agencies, including the self-insured government employees workers’ compensation insurance program and the state risk management programs. Its mission is to enable State of Texas agencies to protect their employees, the general public, and the State’s physical and financial assets by reducing and controlling risk in the most efficient and cost effective manner.
How to Apply
You may apply to the job directly through the CAPPS Career System.
Or, you can mail a State of Texas application (Word) to:
- Linda Griffin, Director of Talent Management
- State Office of Risk Management
- P.O. Box 13777
- Austin, TX 78711-3777
Applicants may direct inquiries to Linda Griffin, Director of Talent Management, at email@example.com.