L&I Program Coordinator/Claim Processor, Bilingual (Spanish)

State of Washington; Tumwater (WA); On-site; USD 42,000 - 62,000; Full time

Job summary

The State of Washington’s L&I agency seeks a bilingual Program Coordinator/Claim Processor to support insurance services and claims administration in Tumwater. The role requires English and Spanish fluency, accurate data handling, and coordination with claim managers to improve adjudication efficiency.

Initial six months of in-office training in Tumwater, WA, followed by potential hybrid schedules. Applicants should meet education and typing requirements and be prepared for confidential handling

Qualifications

• High school graduation or equivalent.
• Two years of experience in the program specialty.
• Equivalent education/experience.

Responsibilities

• Correspond in English and Spanish with internal and external customers via phone.
• Respond to inquiries to resolve questions and concerns by reviewing claim file information.
• Issue payments for the first three days of time loss as directed by the claim manager and in compliance with policies.
• Review, prioritize and process mail items for claim files.
• Perform file reviews to bookmark key information for adjudication.
• Create and maintain records of activities and communications.
• Receive, review, and act on secured messages and suspended bills.
• Respond to claim file requests while protecting confidentiality.
• Compile reports and presentations.
• Provide back up coverage for other claim processors.

Skills

Typing 40 wpm

Bilingual: English/Spanish

Spreadsheet basics (Excel)

Education

High school diploma or equivalent

Two years of experience in the program specialty

Tools

LINIIS

ORION

Job description

Our Mission: Keep Washington Safe and Working! Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability

Please Note: This position requires in-office training for the first 6 months (Office location is Tumwater, WA).

Employees with bilingual responsibilities receive a 5% increase in pay.

The Program Coordinator/Claim Processor, reporting to the Claim Unit Supervisor within Insurance Services, Claims Administration, performs work actions on behalf of the unit claim managers. The Claim Processor exercises independent judgment in the performance of assigned work activities. Utilizing program knowledge and experience in compliance with Title 51, agency policy, program procedures, practices, established tasks and standards, this position performs customer service; reviews and processes routine activities, documents actions, and works from established task lists. The activities of this position are designed to process non-adjudicative actions to permit claim managers more time to focus on complex adjudication activities of their assigned caseloads.

This is a bilingual position, and you will need to fluently speak, read, and write in English and Spanish.

The assigned duty station for this position is Tumwater, Washington.

Some of what you’ll do:

• Correspond in English and Spanish with internal and external customers (injured workers, providers, representatives and internal staff) through answering incoming phone calls.
• Respond to inquiries to resolve customer questions and concerns through a review of the claim file information.
• Issue payments for the first three days of time loss as directed by the claim manager and in compliance with policies and procedures.
• Review, prioritize and process mail items, such as removing duplicate messages, requesting information to be added to a claim file, etc.
• Perform file reviews to bookmark key information in claim files to improve efficiency for claim managers and permit clear focus on adjudication of the complex issues in each claim.
• Create and maintain records of activities including responding to claim file requests, interpreting and updating electronic claim files, documenting actions via emails and system notifications.
• Receive, review, and take routine action on secured messages and suspended bills.
• Responding to claim file requests, ensuring confidentiality and privacy rules are followed.
• Compile reports and presentations.
• Provide back up and coverage activities for other claim processors within each designated service area.

Required:

High school graduation or equivalent

AND

Two years of experience in the program specialty

OR

Equivalent education/experience

AND

• Ability and skill to keyboard at a minimum of 40 words per minute, accounting for errors, with a 5-minute typing test. To see a typing assessment that meets the requirements visit www.typing.com/student/tests. Select and take the 5-minute assessment. Take a screen shot of your result, save, and attach during the online application process. Please do not send a link.
• The ability to fluently speak, read, and write in English and Spanish.

Required Equity Competencies

• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.

Desired:

Spreadsheet Skills – Level 1: Use spreadsheet software such as Microsoft Excel to create, modify, print and format spreadsheets, find and replace data and work with basic formulas and functions. Use templates, styles, AutoFormats, and multiple worksheets.

Six (6) months experience in a call center environment.

Demonstrated research and problem-solving skills.

Excellent communication skills; verbal, written and presentation.

Demonstrated attention to detail.

Be able to access and move between multiple computer programs; databases, word processing, imaging systems, and Internet to enter and update information.

Working knowledge of Title 51, Claims Administration policies, practices and work standards.

Working knowledge of claims operation systems including LINIIS and ORION.

Things You Need To Know

Other work schedules, including hybrid telework, can be considered after the 6-month classroom training is complete.

State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee’s career.

L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3.3 million workers. Take a look at this brief video and learn more about why L&I is an employer of choice.

L&I is an employer of choice. In addition, L&I is a diverse state agency dedicated to the safety and health and security of Washington's 3 million workers.

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 by the Washington 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 million workers.

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.

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.