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The Office of the Ombuds for Self-Insured Injured Workers is looking for a highly skilled adjudicator with experience managing self-insured workers' compensation claims. Our ideal candidate will have expert knowledge of industrial insurance law, mediation skills, and problem solving abilities to resolve confidential claims issues. Our cases are often complex and require an individual with just the right combination of communication skills and technical ability to achieve a successful outcome. This is your opportunity to make a positive difference in the lives of injured workers by ensuring they receive the appropriate benefits under the law.
- Work under the direction of the Self-Insured Worker Ombuds
- Act as an advocate for the injured worker to ensure they receive the appropriate benefits under the law
- Apply RCW, WAC, policies, and relevant case law to assess entitlement to worker compensation benefits
- Negotiate and resolve issues concerning workers of self-insured employers
- Respond to inquiries, conduct fact-finding investigations
- Track and monitor complaints, issues, and outcomes
- Establish and maintain working relationships with injured workers, self-insured employers, third party administrators, department self-insurance adjudicators, and other stakeholders
- Advise Ombuds of complex or reoccurring issues and assist with process improvements
- Assist Ombuds in the implementation of the customer outreach program
A Bachelor's degree or Washington Self-Insurance certification and 2 years' of experience in adjudication of time loss claims in a Washington State workers' compensation insurance program, preferably self-insurance.
Individuals with expert knowledge of industrial insurance law, skilled in adjudicating time-loss claims in a worker's compensation program with a minimum of three years of experience.
In addition to the above-required experience, experience/training in mediation and negotiation and experience with self-insurance.
What we are looking for:
- Ability to apply RCW, WAC, policies, and relevant case law to assess entitlement to worker compensation benefits
- Proficient in Microsoft Office programs; Word and Excel
- Proficient in utilizing and learning claims management systems
- Strong clear written and verbal communication skills
- Refined interpersonal skills, ability to be flexible and adaptable to new situations
- Develop, compile, prepare and present information to groups of all sizes
- Honest, respectful and professional in all interactions
- Accessible, timely, courteous in addressing customers' inquiries and complaints
- Assess issues, evaluate options, form conclusions and make decisions
- Consult and employ expertise and credibility
- Collaborative approach in identifying, evaluating, and resolving issues
- Mediate disputes and negotiate agreements
- Cultivate working relationships with internal and external stakeholders
- Strong investigation, organization, and documentation skills
- Work effectively in a diverse and team focused work environment
- Maintain highest level of confidentiality
In addition to your application, the process requires you to include a cover letter/letter of interest and resume clearly addressing the above section of job announcement titled: "What we are looking for" to be including in your application package.
Interested in being part of a team where you can really make
a difference? A growing Third Party
Administrator of Workers’ Compensation claims located in Portland, Oregon, is
looking for a Claims Examiner with strong Oregon/Washington State claims handling
skills with at least five years of experience handling indemnity claims. Oregon Claims Examiner Certification is
required and Washington certification is a plus. We support low claim loads and a positive
team environment where you will be an integral member.
To learn more about us visit our website at www.intermountainclaims.com
The Workers’ Compensation Trust and Unemployment Pool seeks a Claims Consultant for Workers’ Compensation Trust (WCT) to evaluate, process, and manage workers’ compensation claims within the guidelines of industrial insurance laws and state regulations, documenting activities, and conveying information regarding claims and benefits.
PSESD is one of nine regional educational agencies serving school districts and state approved charter and private schools in Washington. Serving over 39% of Washington’s K-12 public school students, our agency provides critical services designed to ensure that our students are ready to enter school, achieve at high levels in the K-12 system, and succeed in postsecondary endeavors. To learn more about PSESD, visit www.psesd.org
- AA degree in job related field (HS Diploma/GED and progressively responsible work-related experience may substitute for AA degree).
- Professional experience with workers’ compensation
- Holds or is actively pursuing certifications: Associate in Claims (AIC), Washington Workers’ Compensation Professional (WCCP), and/or state certified to adjudicate workers’ compensation claims
- Completed Washington Self Insurer Association courses
Please note, applicants should describe their experience meeting minimum qualifications (and preferred qualifications if applicable) in cover letter and resume as part of the application and salary placement process.
Job Type: Full-time, year ‘round, 40 hours/week
Salary: $70,071-81,260/year (Band J)
Department: Puget Sound Workers' Compensation Trust/Unemployment Pool
We attract, retain, and motivate exceptional people with an equitable
and competitive compensation package. Salary offers consider candidate
qualifications, experience and internal equity.