Claims Team Lead

King County•Seattle, WA

6d•Hybrid

About The Position

This recruitment is open to King County employees only. The Central Employee Services Division within King County's Department of Human Resources (DHR) seeks a seasoned Workers’ Compensation Claims expert to fill a key role in the day-to-day operations of the Safety and Claims Section. Reporting to the Claims Officer Supervisor, the Claims Team Lead will be the technical expert in claims management and will manage the more complex cases within the unit. The successful candidate will be responsible for database and claims management, staff and project development, and serve as lead for the Claims Officers. This role requires outstanding interpersonal, team building, and communication skills: and a deep knowledge of and experience with the professional and regulatory workers’ compensation environment in Washington state. In accordance with industrial insurance legal requirements and claims management standards of King County, a self-insured entity in Washington State, the County is responsible for self-administering its own Workers' Compensation program. As one team, the Central Employee Services Division supports a thriving King County employment experience and provides integrated compensation, benefits, work/life well-being, safety, and retirement planning services. Ensuring the health and safety of employees is our number one priority.

Requirements

Six years of experience managing and processing industrial claims with disability benefits, including vocational rehabilitation OR any equivalent combination of experience and education which provides the applicant with the desired skills, knowledge, and ability required to perform the work.
A minimum of one (1) year experience in adjudicating Washington State Workers' Compensation claims
Claims Administration Certification by the Washington State Department of Labor and Industries OR Washington Workers' Compensation Professional certification
Experience in directing the work of others with the ability to lead, mentor, and coach staff members to work cooperatively and effectively.
Possess strong negotiation and communication skills.
Be able to manage diverse and potentially conflicting perspectives and backgrounds.
Experience developing and presenting training information, using handouts, materials, visual aids, and other tools for group and one-on-one instruction in person or via online platforms.
Experience with database management and creating reports; coordinating, monitoring, and tracking analytical and statistical information.
Knowledge of state laws, regulations, and relevant court rulings regarding workers' compensation; knowledge of standard medical and legal terminology, practices, and procedures; knowledge of investigation and adjudication practices of industrial insurance claims.
Ability to calculate claims related figures quickly and accurately.
Excellent oral and written communication skills, and the ability to communicate with diverse individuals at all levels, both internally and externally.
Demonstrated problem-solving and analytical skills with the ability to manage multiple and shifting priorities to meet deadlines, while working under pressure and considering broad impacts to meet customer service expectations and regulatory deadlines.
Demonstrated commitment to deliver courteous, sensitive, and responsive service to all internal and external customers with the ability to act with the utmost integrity in all professional interactions.
Intermediate level proficiency with Microsoft Office Suite and data management software and demonstrated ability to quickly learn new technology tools.
Experience and demonstrated ability to work effectively and collaboratively with individuals from diverse backgrounds, including sensitivity to and knowledge of various ethnic, cultural, and socioeconomic backgrounds.

Nice To Haves

Experience working with Washington State Self Insured employers for the purpose of workers compensation.

Responsibilities

Serve as a technical expert and team lead within the unit.
Provide leadership, technical assistance, and training to staff and partners on best practices in claims management.
Perform general audit functions of claims in iComp (Claims Processing system) for quality assurance and continuously monitor the quality and efficiency of the claims adjudication process.
Assist the Claims Officer Supervisor with policy recommendations and creating standard operating procedures for the claims adjudication processes.
Assist the Claims Officer Supervisor with the development and facilitation of training and education of King County supervisors and employees on workers’ compensation policies and processes, through written materials and presentations.
Assist Claims Officer Supervisor in coordinating, monitoring, and tracking analytical and statistical information related to workers’ compensation and the production of relevant reports and recommendations.
Manage all data gathering for performance reviews of Claims Officers, conduct claim reviews and audits, and review penalties.
Provide performance evaluation input for program staff to Claims Officer Supervisor.
Propose scope of work and goals for ad hoc assignments or projects for Claims Team.
Perform data collection and conduct analyses for assigned research projects; prepare summary reports of analyses and presentation of findings.
Provide, lead or conduct required analyses, including compliance with all relevant laws and regulations that affect workers’ compensation administration.
Evaluate new regulations, laws and legislation for impact on services and program goals.
Develop and/or modify existing processes for new regulations, laws and legislation with Claims Officer Supervisor.
Manage a limited caseload of complex workers’ compensation claims to closure or settlement.
Claims Team Lead will have limited claim settlement authority to resolve claims.
Onboard and train newly hired Claims Officers to the unit in partnership with the Claims Officer Supervisor.
Resolve concerns and issues from injured workers, attorney representatives, regulators and other partners that interact with the workers compensation program.
Serve as a subject matter expert on third party issues, payroll systems, and time loss calculations and processing.
Other duties as assigned.