L&I Workers’ Compensation Adjudicator 3

Full 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 recruitment is for Internal Washington State Department of Labor & Industries (L&I) employees only

Job Highlights

The Department of Labor & Industries is seeking a Self-Insurance Workers’ Compensation Adjudicator 3 (WCA 3).

As a WCA3 you will be responsible for providing impartial oversight and expert services to the self-insured community and reducing economic hardship to injured workers by adjudicating benefit requests within the program’s performance measurements and expectations.

In this position, you will ensure adjudicative decisions are based on laws, rules, policies, and established work standards.

You will be required to make legally binding decisions regarding workers’ benefit entitlement.

In addition, you will be responsible for resolving worker disputes, protests, and recommend penalties when appropriate.

If you want to be a part of an integral team that supports our agency’s mission to Keep Workers Safe and Working, apply today.

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.

What we are looking for:

• Strong problem solving and decision-making skills.
• Strong interpersonal skills with the ability to communicate effectively both verbally and in writing.
• Strong customer service skills with the ability to listen and connect with others to build and maintain internal and external customer satisfaction even when assisting upset, confused or demanding customers.
• Ability to independently research and gather information.
• Time management and organizational skills.
• Experience working in a high-paced environment with specific deadlines and frequent interruptions.

Requirements

Some of what you will do:

• Review claim files and apply the law to allow or deny new claims filed for workplace injuries or occupational diseases.
• Authorize or deny wage replacement benefits, and if payable, establish the rate of compensation.
• Make vocational services referrals to include early return to work, vocational assessments, plan development and approval of vocational retraining plans.
• Make determination to allow or deny requests to reopen claims closed for more than 60 days and review and investigate requests for accident fund benefits after the statutory limitations.
• Research medical or legal issues for claim file action using RCW, WAC, policies, case law and training.
• Authorize or deny a worker’s medical treatment, surgery, independent medical examinations, diagnostic studies, transfer of health care providers, and other types of treatment and reimbursement of worker’s travel expenses using the Medical Aid Rules and department coverage decisions.
• Respond to inquiries regarding claim benefits, legal rights, the department’s rules and regulations, and the claim adjudication process.
• Prepare a variety of claim file correspondence such as letters and legal orders.
• Document all claim interactions and decisions and ensure compliance with laws, rules, policies, and case law.
• Document treatment authorizations for medial treatment adjudicator to review and make appropriate payment.
• Issue a legal order granting or denying reopening within 90 calendar days.
• Issue orders resolving protests and send letters of explanation to all parties.
• And much more!

Qualifications

Required:

Bachelor's degree in business administration, public administration or closely allied field.

AND

Two 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

Six (6) months of experience as a Workers’ Compensation Adjudicator 2.

OR

Equivalent education/experience.

AND

**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.

Desired:

Additional Information

Things You Need To Know

At L&I, your voice matters. L&I is a diverse state agency dedicated to the safety, health and security of Washington's 3.3 million workers. Watch this brief video and learn more about why L&I is an employer of choice.

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. Click on the “Benefits” tab to learn more.

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 completion of training and approval by management.

During the training period you will be expected to work a 5/8’s schedule of 7:00 – 3:30 p.m. or 8:00 – 4:30 p.m.

For this position, you will be allowed to telework up to full time with the expectation of attending in-person meetings, training, or upon business needs. The assigned duty station for this position is Tumwater, Washington.

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:

1. A cover letter describing specific qualifications.
2. A current resume detailing applicable experience and education.
3. A list of at least three professional references with current telephone numbers.

Please do not attach or place any medical information (vaccination status included) within the application, resume, or cover letter.

If you do, we will have to reject your application to safeguard others from receiving your confidential information. You will have to remove the confidential information before you can apply again.

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 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.

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 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 HRBTU@lni.wa.gov. #LI DNI