L&I Workers' Adjudicator​/Case Reserve​/Claims State Funded

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 position is open to current Internal L&I applicants only.

Are you looking to grow your career in Insurance Services? Put your skills to work in the Case Reserve Unit.

Joining the Case Reserve Unit is a great way to get a unique perspective on important aspects of the department's activities and to build on the knowledge and skills you already have. As a Workers’ Compensation Adjudicator 3 in Case Reserve, you will learn about claim cost expectancy and how it affects employers’ rates. You will build a network of relationships with other Agency divisions such as Actuaries, Employer Services, Investigations, Third Party, and the Settlement Unit that utilize our case reserves.

With less phone calls and fewer interruptions, our reservists are able to focus on producing quality cost estimates that our customers have come to rely on.

Case Reserve is one of the best places to be a WCA3, and it provides great experience for your career.

Case Reserve is right for you, if you…

• Enjoy learning the story of a claim.
• Like considering the big picture.
• Want to do work that matters? Case reserve helps keep the state fund solvent, ensures employers are rewarded for keeping claim costs down, ensures penalties are accurate to unregistered employers, provides information for negotiations when there is a third party involved, and more.

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.

Some Of What You’ll Do

• Perform a thorough file review of all types of state fund claims, extracting information from the claim file to support future cost estimates.
• Interpret medical, vocational and legal information in a claim file to determine future potential costs for individual claims in regards to further medical treatment and vocational services as well as possible pensions.
• Compute an estimated cost for future Time Loss, PPD, Medical, and Vocational Services for the Accident and Medical Aid Funds.
• Document findings to establish an audit trail for the industrial insurance rates.
• Participate in continual improvement efforts to identify issues in case reserving and devise, test, and implement solutions.
• Provide a second set of eyes on claims to assist claim managers (CM) when you identify issues on a claim that the CM may not have seen.
• And much more!

Required:

• Successful completion of the Department of Labor and Industries Workers’ Compensation Adjudicator 2 Apprenticeship program.
• AND
• Six months of experience as a Workers' Compensation Adjudicator 2.
• OR Bachelor's degree
• AND
• Two 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.

Desired: Current L&I employees who have held permanent status as a…