Reimbursement Officer III (22-1057)
Office of the Attorney General
GENERAL DESCRIPTION
Performs highly complex analytical work in the Crime Victims’ Compensation Program. Work involves gathering information to verify physical and/or emotional injuries, financial loss, and
eligibility for claim reimbursement; providing recommendations to award or deny benefits and to calculate the award amounts OAG employees enjoy excellent benefits along with
tremendous opportunities to do important work at a large, dynamic state agency making a positive difference in the lives of Texans. Level of Complexity of State Classification: Highly
Complex Level of Supervision of State Classification: Works under limited supervision, with considerable latitude for the use of initiative and independent judgment.
ESSENTIAL JOB FUNCTIONS
Function Description
Analyzes reports and records to determine the actual out-of-pocket wage loss
Gathers and analyzes information to determine the nature and extent of the victims’ or survivors’ physical or emotional injuries
Obtains funeral agreement and other itemized bills to determine reasonable funeral and burial expenses
Obtains legal documentation to determine loss of support in homicide claims, including proof of financial dependency and proof of the dependents’ economic loss
Investigates available collateral sources of payment, including health insurance plans, public funds, workers’ and unemployment compensation, automobile insurance carriers, and the
offender
Calculates amount of the award and writes the recommendation to award; informs the victims or survivors of the benefits being awarded by the Office of the Attorney General (OAG)
Reviews evidence of injury and medical treatment for the purpose of determining if the injury and medical treatment are a direct result of the crime, and that the cost of medical treatment is
actual, reasonable, and necessary according to the guidelines established by the Texas Workers’ Compensation Medical Fee Guidelines
Contacts physicians and hospitals to obtain medical reports and patient health care reports
Conducts interviews with physicians and other allied health professionals to clarify issues concerning the injury or medical treatment
Contacts the victims’ or survivors’ employer to determine the rate of pay, time loss from work, and the extent of collateral source benefits
Contacts law enforcement officials to obtain evidence receipts supporting claims for replacement of clothing and other property; determines reasonable replacement costs
Obtains proof of the cost of the crime scene clean-up; determines whether the costs are reasonable and necessary
Performs related work as assigned
Maintains relevant knowledge necessary to perform essential job functions
Attends work regularly in compliance with 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
MINIMUM QUALIFICATIONS
Education: Graduation from high school or equivalent
Education: Bachelor's degree from an accredited college or university; may substitute experience in the following (or closely related) fields for the required education on a year-for-year
basis: claims processing, criminal justice, customer experience, social services; or interacting with persons in emotional stress or crisis
Knowledge of Crime Victims’ Compensation Program
Skill in handling multiple tasks, prioritizing, and meeting deadlines
Skill in effective oral and written communication
Skill in exercising sound judgment and effective decision making
Ability to receive and respond positively to constructive feedback
Ability to work cooperatively with others in a professional office environment
Ability to provide excellent customer service
Ability to work in person at assigned OAG work location, perform all assigned tasks at designated OAG work space within OAG work location, and perform in-person work with coworkers
(e.g., collaborating, training, mentoring) for the entirety of every work week (unless on approved leave)
Ability to arrange for personal transportation for business-related travel
Ability to work more than 40 hours as needed and in compliance with the FLSA
Ability to lift and relocate 30 lbs.
Ability to travel (including overnight travel) up to 5%
PREFERRED QUALIFICATIONS
Experience in a medical billing practices and procedures
Experience in a criminal justice, crime victims or social service agency
Knowledge of the issues of victimization and the victim service delivery system in Texas
Other Language: Ability to proficiently read, write, and speak Spanish
TRAVEL
5%
TO APPLY
To apply for a job with the OAG, submit a completed State of Texas job application through the OAG Job Postings Page. In addition, electronic applications can be submitted through either
CAPPS Recruit or Work in Texas. A State of Texas application must be completed to be considered, and paper applications are not accepted. For further instructions on how to apply
through the OAG Job Postings Page, see our How to Apply page. Your application for this position may subject you to a criminal background check pursuant to the Texas Government
Code. Military Crosswalk information can be accessed at http://www.hr.sao.state.tx.us/Compensation/MilitaryCrosswalk/MOSC_AccountingAuditingandFinance.pdf.
THE OAG IS AN EQUAL OPPORTUNITY EMPLOYER
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