L&I Workers' Compensation Adjudicator 5

State of Washington•Thurston County – Tumwater, WA

5d•Hybrid

About The Position

The Department of Labor and Industries’ Self-Insurance Program is seeking a Workers’ Compensation Adjudicator 5 (WCA5) to join their team. This role supports the agency’s mission by assessing and enforcing compliance of the RCWs and WACs governing Self-Insured Employers and Third-Party Administrators’ administering workers’ compensation benefits to employees injured on the job. The incumbent will review recommendations from internal and external parties to determine the appropriateness of the assessment or denial of penalty against Self-Insured employers per statutes and rules. L&I's Self-Insurance Program is dedicated to supporting employers and protecting workers by providing impartial oversight and timely, expert services to the self-insured community. The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety, health, and security of Washington's workers. They help employers meet safety and health standards and inspect workplaces when alerted to hazards. As administrators of the state's workers' compensation system, they are similar to a large insurance company, providing medical and limited wage-replacement coverage to workers who suffer job-related injuries and illness. Their 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.

Requirements

Successful completion of the Department of Labor and Industries Workers’ Compensation Adjudicator 2 Apprenticeship program.
One year of experience as a Workers’ Compensation Adjudicator 4.
Bachelor’s degree AND Four years of experience in adjudicating workers’ or crime victims’ compensation insurance claims, or adjudication of time loss payments.
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

Four years of experience in adjudication of workers’ claims with the Department of Labor and Industries, to include one year of experience as a Workers’ Compensation Adjudicator 4.
Professional designation as a Self-Insurance Certified Claims Administrator or the ability to obtain the certification within 6 months.
Experience working in the Self-Insurance Program and with self-insurance rules and regulations.
Experience in overseeing or managing self-insured claims in Washington State.

Responsibilities

Interprets facts and applies laws and rules when determining assessments of penalties on violations.
Manages a caseload of work item requests by reviewing, adjudicating and assuring decisions are made within management expectations.
Assigns, tracks, and reviews recommendations from level 3, 4 and 5 adjudicators.
Reviews requests for Willful Misrepresentation sent to the department by Self-Insured employers.
Testify on facts regarding department actions for all penalty appeals at the Board of Industrial Insurance Appeals (BIIA).
Give Depositions on penalty decisions for specific claims.
Communicate at other judicially related activities as related to adjudicative level claim decisions.
Occasionally speak publicly regarding penalties and related compliance activities.
Participate in legislative activities including bill analyses and rule-making.