What are the responsibilities and job description for the L&I Workers' Compensation Adjudicator 5 position at Washington State Department of Labor & Industries?
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 enjoy research and investigation to make data-driven decisions? Do you have an interest in quality assurance, compliance, and data analytics? If this sounds like you, you have an opportunity to make a difference and come be part of our Self-Insurance team as our next Workers’ Compensation Adjudicator 5 (WCA 5).
The individual in this position will perform quality assurance reviews and compliance audits of the worker’s compensation programs of self-insured employers and their third-party administrator (TPA). This includes assessing the design adequacy and operational effectiveness, considering risk management and internal controls to ensure operational performance and accountability of the system. In this role, you will also provide expert consultative services to self-insured employers, third party administrators, program managers and division executives. The work of this position ties directly tied to our agency goals and the agency mission To Keep Washington Safe and Working.
Why Work For Us
The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety, health, and security of Washington's workers. We help employers meet safety and health standards and inspect workplaces when alerted to hazards. As administrators of the state's workers' compensation system, we are similar to a large insurance company providing medical and limited wage-replacement coverage to workers who suffer job-related injuries and illness. Our rules and enforcement programs also help ensure workers are paid what they are owed, that children's and teens' work hours are limited, and that consumers are protected from unsound business practices.
Insurance Services is the largest division within the agency and administers one of the premier workers’ compensation organizations in the nation serving over 3.8 million employees working for 260,000 employers.
Here Is What We Are Looking For
Some Of What You’ll Do
Required:
A Bachelor’s degree AND Four (4) years of experience in adjudicating workers’ or crime victims’ compensation insurance claims or adjudication of time loss payments.
OR
Successful completion of the Department of Labor and Industries Workers’ Compensation Adjudicator 2 Apprenticeship program AND One (1) year of experience as a Workers’ Compensation Adjudicator 3 or higher.
OR
Equivalent education/experience.
Things You Need To Know
To help you maintain a proper work-life balance, 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. Click on the “Benefits” tab to learn more.
At L&I, your voice matters. In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.8 million workers. Take a look at this brief video and learn more about why L&I is an employer of choice.
For this position, telework is permitted dependent upon business needs and supervisor approval. The assigned duty station for this position is Tumwater, Washington.
For positions where in-office work is necessary, the frequency of telework will be discussed with the supervisor of the position at the time of offer.
To receive more information on opportunities at L&I sign up for GovDelivery and select L&I job alerts.
Application process
We will contact the top candidates directly to interview for this position. Because we base the selection on information provided by you, it is in your best interest to identify the knowledge, skills, and abilities that address the required and desirable qualifications described in the announcement.
Please Include The Following Documents With Your Application
To learn more about our hiring process timeline at L&I please visit our L&I recruiting page at Hiring Process at L&I . If you would like to read our website in a language other than English, scroll up to the top of the page to select your language of choice from the banner.
Background Check Notice
Prior to a placement in this position, a background check, including criminal history record will be conducted. Information from your background check will not necessarily preclude employment but will be considered in determining your eligibility to perform the requirements of the position.
Other Information
Washington is America's Top State to live, play, and work, according to U.S. News (2021). Join the L&I team and enjoy all the Evergreen State has to offer.
In addition to offering a positive balance between life and work, L&I provides one of the most competitive benefits packages in the nation. We also believe your voice matters. We value our employees and their work-life balance by encouraging flexible schedules. L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.8 million workers.
Veterans Preference
Applicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy), 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. For further information, contact L&I’s Jobs@lni.wa.gov .
Diversity, Equity, and Inclusion Employer
L&I employees come from all walks of life. We strive to hire great people from a wide variety of backgrounds. 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.
We believe in the importance of recognizing the value each of us contribute to the success of the agency mission. Having a diverse workforce is this agency’s greatest resource of strength and knowledge. It is through the combination of talents and abilities that we can pursue finding effective measures to provide the best customer service. We are committed to building a diverse and inclusive workplace for everyone and we strongly mean everyone.
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.
You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.
For more Information
If you have any questions regarding this job posting, program, or the agency, please contact Jacque Crawford at HRBTU@lni.wa.gov .
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 enjoy research and investigation to make data-driven decisions? Do you have an interest in quality assurance, compliance, and data analytics? If this sounds like you, you have an opportunity to make a difference and come be part of our Self-Insurance team as our next Workers’ Compensation Adjudicator 5 (WCA 5).
The individual in this position will perform quality assurance reviews and compliance audits of the worker’s compensation programs of self-insured employers and their third-party administrator (TPA). This includes assessing the design adequacy and operational effectiveness, considering risk management and internal controls to ensure operational performance and accountability of the system. In this role, you will also provide expert consultative services to self-insured employers, third party administrators, program managers and division executives. The work of this position ties directly tied to our agency goals and the agency mission To Keep Washington Safe and Working.
Why Work For Us
The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety, health, and security of Washington's workers. We help employers meet safety and health standards and inspect workplaces when alerted to hazards. As administrators of the state's workers' compensation system, we are similar to a large insurance company providing medical and limited wage-replacement coverage to workers who suffer job-related injuries and illness. Our rules and enforcement programs also help ensure workers are paid what they are owed, that children's and teens' work hours are limited, and that consumers are protected from unsound business practices.
Insurance Services is the largest division within the agency and administers one of the premier workers’ compensation organizations in the nation serving over 3.8 million employees working for 260,000 employers.
Here Is What We Are Looking For
- Your ability to research, analyze, and evaluate data to draw conclusions and make recommendations supported with facts.
- Your ability to understand and communicate complex processes in a clear, concise and simplified way to others both orally and in writing.
- Your ability to collaborate and build positive, respectful working relationships with clients and co-workers
- Your ability to exercise expert-level professional judgment in applying audit practices.
- Your experience and ability to resolve conflict when dealing with clients who may be angry, distraught, or frustrated.
- Your critical thinking and attention to detail skills will be assets in this position.
Some Of What You’ll Do
- Conduct performance based in depth compliance audits.
- Collaborate on quality management risk assessments and developments of annual audit plans.
- Design specific procedures, checklists, tools and tests to achieve objectives and deadlines.
- Research and investigate complaints submitted by customers against insurance company failed action allegations.
- Use computer assisted auditing techniques to conduct cross-system data pulls.
- Use data analytical techniques to identify trends and anomalies.
- Independently conduct complex analysis and in-depth reviews to measure and evaluate compliance with Title 51 (RCW), WACs, policies, and standards of self-insured employers.
- Conduct interviews with self-insurance employer executives and managers, employees and third-party administrator staff.
- Develop directive specific training to self-insured employers.
- Prepare written reports with executive summary of findings and recommendations for remedial action
- Analyze audit findings and assess risk for future nonconformance using independent judgment.
- And much more!
Required:
A Bachelor’s degree AND Four (4) years of experience in adjudicating workers’ or crime victims’ compensation insurance claims or adjudication of time loss payments.
OR
Successful completion of the Department of Labor and Industries Workers’ Compensation Adjudicator 2 Apprenticeship program AND One (1) year of experience as a Workers’ Compensation Adjudicator 3 or higher.
OR
Equivalent education/experience.
- Additional experience working with insurance claims, claims/insurance adjusting, claims investigations, disability management, claims risk management/loss control, medical billing, medical insurance, paralegal personal injury services or paramedical occupations will substitute, year for year, for required education.
- The ability to take action to learn and grow.
- The ability to take action to meet the needs of others.
- One year of specialized experience adjudicating self-insurance claims.
- Professional designation as a Self-Insurance Certified Claims Administrator or the ability to obtain the certification within 6 months of starting this position.
- One year of specialized experience adjudicating self-insurance claims.
Things You Need To Know
To help you maintain a proper work-life balance, 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. Click on the “Benefits” tab to learn more.
At L&I, your voice matters. In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.8 million workers. Take a look at this brief video and learn more about why L&I is an employer of choice.
For this position, telework is permitted dependent upon business needs and supervisor approval. The assigned duty station for this position is Tumwater, Washington.
For positions where in-office work is necessary, the frequency of telework will be discussed with the supervisor of the position at the time of offer.
To receive more information on opportunities at L&I sign up for GovDelivery and select L&I job alerts.
Application process
We will contact the top candidates directly to interview for this position. Because we base the selection on information provided by you, it is in your best interest to identify the knowledge, skills, and abilities that address the required and desirable qualifications described in the announcement.
Please Include The Following Documents With Your Application
- A cover letter describing specific qualifications.
- A current resume detailing applicable experience and education.
- A list of at least three professional references with current telephone numbers.
To learn more about our hiring process timeline at L&I please visit our L&I recruiting page at Hiring Process at L&I . If you would like to read our website in a language other than English, scroll up to the top of the page to select your language of choice from the banner.
Background Check Notice
Prior to a placement in this position, a background check, including criminal history record will be conducted. Information from your background check will not necessarily preclude employment but will be considered in determining your eligibility to perform the requirements of the position.
Other Information
- For positions requiring travel, you must have a valid unrestricted driver's license and have insurance if driving a privately owned vehicle on state business.
- This position is represented bytheWashington Federation of State Employees (WFSE).
- Candidates who are offered a job with L&I must possess work authorization that does not require sponsorship by the employer for a visa now or in the future.
- The Department of Labor & Industries complies with the employment eligibility verification requirements of the federal employment eligibility verification form, I-9. The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form on the first day of employment.
- Please note: L&I may use this announcement to fill multiple permanent and/or non-permanent positions.
Washington is America's Top State to live, play, and work, according to U.S. News (2021). Join the L&I team and enjoy all the Evergreen State has to offer.
In addition to offering a positive balance between life and work, L&I provides one of the most competitive benefits packages in the nation. We also believe your voice matters. We value our employees and their work-life balance by encouraging flexible schedules. L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.8 million workers.
Veterans Preference
Applicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy), 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. For further information, contact L&I’s Jobs@lni.wa.gov .
Diversity, Equity, and Inclusion Employer
L&I employees come from all walks of life. We strive to hire great people from a wide variety of backgrounds. 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.
We believe in the importance of recognizing the value each of us contribute to the success of the agency mission. Having a diverse workforce is this agency’s greatest resource of strength and knowledge. It is through the combination of talents and abilities that we can pursue finding effective measures to provide the best customer service. We are committed to building a diverse and inclusive workplace for everyone and we strongly mean everyone.
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.
You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.
For more Information
If you have any questions regarding this job posting, program, or the agency, please contact Jacque Crawford at HRBTU@lni.wa.gov .
Salary : $69,348 - $93,288