L&I Workers' Compensation Adjudicator 4 - Unit Lead/Wage Specialist

Washington State Department of Labor & Industries; Seattle (WA); Hybrid; USD 75,000 - 110,000; Full time

Benefits offered by this job

Hybrid work model

Telework options

Paid leave

Tuition reimbursement

Infants at Work Program

Retirement package

Job summary

Washington State Department of Labor & Industries seeks a Workers’ Compensation Adjudicator 4 (WCA4), Unit Lead Wage Specialist, to join the Self Insurance Program. You will serve as a technical resource on complex wage and claim issues and support the Director with discretionary decisions.

This role emphasizes quality assurance, mentoring, and ensuring decisions comply with rules, regulations and laws, with a hybrid work model and statewide impact.

Qualifications

• Successful completion of the WCA2 Apprenticeship or equivalent education/experience.
• Experience adjudicating workers’ compensation or related claims is preferred.
• Ability to interpret complex policies and laws and apply them accurately.

Responsibilities

• Manage and adjudicate a caseload of complex protests from injured workers or employers.
• Issue legal orders resolving protests and compose explanations.
• Gather and issue complex wage orders for unit, Social Security Offset, and Pension.
• Serve as a technical resource for the supervisor and adjudicators.
• Provide quality assurance reviews on unit work.
• Coach and mentor unit claim managers to ensure policy compliance.

Skills

Wage adjudication

Policy interpretation

Data analysis

Customer service

Mentoring

Education

Bachelor's degree or equivalent experience

Tools

MS Word

Excel

Job description

OR

Equivalent education/experience.

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

The Department of Labor and Industries is seeking a Workers’ Compensation Adjudicator 4 (WCA4), Unit Lead Wage Specialist, to join our team in the Self Insurance Program within our Insurance Services Division.

In this position, you will serve as a technical resource to the unit Claims Supervisor, unit staff, and the self-insured community on complex wage and claim issues. You will make recommendations to the Director for discretionary items and perform quality reviews of adjudicative actions of internal staff to ensure decisions are based on rules, regulations and laws.

This position directly supports the agency mission by reducing the economic hardship to injured workers and self-insured employers by adjudicating benefit requests within the program’s performance measurements and expectations.

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.

The Insurance Services Self-Insurance program is dedicated to supporting employers and protecting workers by providing impartial oversight and timely, expert services to all employers in Washington State that elect to administer and pay their own workers’ compensation claims.

Here Is What We Are Looking For

• Ability to effectively communicate complex information clearly and succinctly in a way that is easy to understand for a variety of audiences both orally and in written format.
• Ability to review, independently interpret, analyze, and apply specialized program policies and procedures to draw sound conclusions and make recommendations and decisions based on data.
• Strong customer service skills with the ability to authentically listen and collaborate with others from diverse backgrounds to build and maintain internal and external customer satisfaction.
• Demonstrated critical thinking and analytical skills.
• Ability to effectively organize multiple assignments and remain focused on priorities and progress to produce work products that are accurate, thorough and on time.
• Demonstrated ability to build rapport and partner with others to contribute to respectful working relationships and team cohesion.
• Knowledge and experience of Washington’s Workers’ Compensation claims management processes and calculating wages for injured workers.
• Ability to coach and mentor others to ensure consistent interpretation of policies, procedures and laws and work products comply with production and quality standards.

Duties

Some Of What You’ll Do

• Manages and adjudicates a caseload of complex protests made by injured workers, physicians, self-insured employers or their attorneys, from decisions involving entitlement to benefits, jurisdictional matters, and contested determinations.
• Issues legal orders resolving protests and composes letters of explanation.
• Gather and issue complex wage orders for unit, Social Security Offset, and Pension.
• Acts a technical resource for the supervisor and claim unit adjudicators.
• Provide quality assurance reviews on unit work.
• Coach and mentor unit claim managers, including trainees, to ensure compliance with production and quality standards.
• Prepare briefing papers for the Director to make decisions for benefits on Over-Seven re-opening applications and requests for Waiver of Overpayments.
• And much more!

Qualifications

Required

• 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

• Bachelor’s degree AND Three (3) years of experience in adjudicating workers’ or crime victims’ compensation insurance claims, or adjudication of time-loss payments

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.

AND

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

Desired

• Ability to manage time, prioritize work to best accomplish the workload and manage the work schedule.
• Excellent written and verbal communication skills.
• Must have ability to apply critical reasoning skills.
• Receptive to change and adaptable to new situations and processes.
• Ability to effectively communicate with and assist difficult people.
• Be a team player with a positive attitude and ability to build rapport.
• Skilled in using personal computers and software, i.e., MS Word and Excel.

Supplemental Information

Things You Need to Know

L&I provides a modern work environment and excellent benefits including paid leave, tuition reimbursement, Infants at Work Program and a generous retirement package for qualified employees at the end of their career.

We value our employees and their work-life balance. We support a hybrid work model and offer flexible custom work schedules. This position is eligible for a flexible schedule (4/10’s, 9/80’s, 5/8’s, etc.) upon approval by management.

For this position, teleworking is permitted full time. The assigned duty station for this position is Tumwater, Washington.

Background Check Notice

Prior to a placement in this position, a background check, including criminal history records 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

• Applicants selected to move forward in the hiring process will be contacted to complete a skills assessment. Assessments are conducted virtually via Microsoft Teams.
• 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 bythe 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.

Did You Know?

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.

Veterans Preference

Applicants wishing to claim Veterans Preference should attach to your application a copy of your 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 [e-mail] .

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 contributes to the success of the agency mission. Having a diverse workforce is this agency’s greatest source 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 Angela Laramie at [e-mail] .