Senior Workers' Comp Adjudicator & Claim Manager

Washington State Health Care Authority; Tumwater (WA); Remote; USD 80,000 - 105,000; Full time

Job summary

The Washington State Department of Labor & Industries seeks a Workers’ Compensation Adjudicator 3/Claim Manager to independently manage a high-complexity caseload of industrial insurance claims. The role supports timely, accurate medical and wage replacement benefits for injured workers.

Responsibilities include evaluating claims under RCWs and WACs, mentoring junior staff, and providing direct customer service while maintaining confidentiality and professionalism.

Qualifications

• Successful completion of the WCA 2 Apprenticeship program.
• Six months of experience as a Workers’ Compensation Adjudicator 2 by January 16, 2027.
• Bachelor’s degree or equivalent education/experience.
• Experience with insurance claims adjudication or related fields preferred.

Responsibilities

• Manage a caseload; review and adjudicate industrial insurance claims per laws and case law.
• Interpret facts and apply the law to determine claim validity and actions.
• Decide time-loss eligibility and issue wage orders when needed.
• Respond to protests, board/court orders, and reopenings; communicate decisions.
• Provide direct customer service and respond to inquiries about claims and rules.
• Prepare claim file correspondence and investigation assignments.
• Mentor lower-level adjudicators to use independent judgment.
• Work with RCWs, WACs, and department procedures.

Skills

Mentoring

Research & analysis

Regulations understanding

Customer service

Education

WCA Apprenticeship

Bachelor’s degree

Tools

Microsoft Office

Job description

The Washington State Department of Labor & Industries seeks a Workers’ Compensation Adjudicator 3/Claim Manager to independently manage a high-complexity caseload of industrial insurance claims. The role supports timely, accurate medical and wage replacement benefits for injured workers.

Responsibilities include evaluating claims under RCWs and WACs, mentoring junior staff, and providing direct customer service while maintaining confidentiality and professionalism.