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

State of Washington•Thurston County – Tumwater, WA

6d•Hybrid

About The Position

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. 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.

Requirements

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

Nice To Haves

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.

Responsibilities

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.