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

State of Washington • Thurston County – Tumwater, WA

2d • Hybrid

About The Position

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

Requirements

• High school graduation or equivalent AND Two years of experience in the program specialty OR Equivalent education/experience
• Ability and skill to keyboard at a minimum of 40 words per minute, accounting for errors, with a 5-minute typing test.
• The ability to fluently speak, read, and write in English and Spanish.
• The ability to take action to learn and grow.
• The ability to take action to meet the needs of others.

Nice To Haves

• 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.

Responsibilities

• 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.

Benefits

• Employees with bilingual responsibilities receive a 5% increase in pay.
• State employees who meet the qualifications will become eligible for a generous retirement package at the end of the employee’s career.
• 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 value our employees and their work-life balance by encouraging flexible schedules.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED