L&I Worker's Compensation Adjudicator 1
Washington State Department of Labor & Industries, Seattle, WA, United States
Description
Our Mission: Keep Washington Safe and Working!
Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability.
Job Highlights
Do you have experience working in a medical, insurance, or legal environment? If so, you have an excellent opportunity.
As a Worker’s Compensation Adjudicator 1 in the Self-Insurance program of the Insurance Services Division, you contribute to the state’s economic well-being by providing expert services to the self‑insured community and ensuring injured workers receive relief regarding their industrial insurance benefits.
In this fast‑paced environment, with competing priorities, the ideal candidate demonstrates strong capabilities in time‑management, decision making, attention to detail, oral and written communication, organizational skills, and confidentiality.
Duties
Reviews, adjudicates, and ensures decisions are made within management expectations and in accordance with RCW’s, WACs, case laws, and department rules and policies.
Interprets facts and applies laws and rules to determine injury claim allowance.
Issues legal orders and resolves protests on medical‑only claims.
Reviews and adjudicates bill disputes from PT/OT/MT and interpreter providers.
Works on special projects, participates in work‑process improvement teams, and serves on other committees.
Reviews and adjudicates claim consolidation requests for duplicate claims with same date of injury.
Receives and processes Self‑Insured Electronic Data Reporting System (SIEDRS) data change requests.
Qualifications
High school diploma or equivalent AND at least three (3) years of experience working with insurance claims or in claims/insurance adjusting, claims investigations, paramedical occupation, disability management, claims risk management/loss control, medical billing, medical insurance, paralegal personal injury services or closely related field.
Type at minimum 40 words per minute, accounting for errors.
Demonstrated ability to take action to learn and grow.
Ability to take action to meet the needs of others.
Desired: Adjudicative claim experience in the State Fund sections of the Department of Labor and Industries or the Self‑Insured Community; ability to apply appropriate force to push/pull items weighing up to 30 pounds; ability to sit and/or stand for long periods of time.
Benefits and Work Schedule
Teleworking is one of the work‑schedule options for this position. L&I also offers flexible custom work schedules. State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee’s career.
Workstation
Workstation: Tumwater, Washington (telework dependent on business needs and supervisor approval).
Veteran Preference
Applicants wishing to claim Veterans Preference should attach a copy of their DD‑214 (Member 4), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers.
EEO Statement
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. The State of Washington is an equal‑opportunity employer. Persons with a disability who need accommodation in the application process or testing process, or those needing this announcement in an alternative format, may call 360‑902‑5700. TTY users should first call 711 to access the Washington Relay Service.
#J-18808-Ljbffr
Our Mission: Keep Washington Safe and Working!
Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability.
Job Highlights
Do you have experience working in a medical, insurance, or legal environment? If so, you have an excellent opportunity.
As a Worker’s Compensation Adjudicator 1 in the Self-Insurance program of the Insurance Services Division, you contribute to the state’s economic well-being by providing expert services to the self‑insured community and ensuring injured workers receive relief regarding their industrial insurance benefits.
In this fast‑paced environment, with competing priorities, the ideal candidate demonstrates strong capabilities in time‑management, decision making, attention to detail, oral and written communication, organizational skills, and confidentiality.
Duties
Reviews, adjudicates, and ensures decisions are made within management expectations and in accordance with RCW’s, WACs, case laws, and department rules and policies.
Interprets facts and applies laws and rules to determine injury claim allowance.
Issues legal orders and resolves protests on medical‑only claims.
Reviews and adjudicates bill disputes from PT/OT/MT and interpreter providers.
Works on special projects, participates in work‑process improvement teams, and serves on other committees.
Reviews and adjudicates claim consolidation requests for duplicate claims with same date of injury.
Receives and processes Self‑Insured Electronic Data Reporting System (SIEDRS) data change requests.
Qualifications
High school diploma or equivalent AND at least three (3) years of experience working with insurance claims or in claims/insurance adjusting, claims investigations, paramedical occupation, disability management, claims risk management/loss control, medical billing, medical insurance, paralegal personal injury services or closely related field.
Type at minimum 40 words per minute, accounting for errors.
Demonstrated ability to take action to learn and grow.
Ability to take action to meet the needs of others.
Desired: Adjudicative claim experience in the State Fund sections of the Department of Labor and Industries or the Self‑Insured Community; ability to apply appropriate force to push/pull items weighing up to 30 pounds; ability to sit and/or stand for long periods of time.
Benefits and Work Schedule
Teleworking is one of the work‑schedule options for this position. L&I also offers flexible custom work schedules. State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee’s career.
Workstation
Workstation: Tumwater, Washington (telework dependent on business needs and supervisor approval).
Veteran Preference
Applicants wishing to claim Veterans Preference should attach a copy of their DD‑214 (Member 4), NGB 22, or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers.
EEO Statement
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. The State of Washington is an equal‑opportunity employer. Persons with a disability who need accommodation in the application process or testing process, or those needing this announcement in an alternative format, may call 360‑902‑5700. TTY users should first call 711 to access the Washington Relay Service.
#J-18808-Ljbffr