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This is a range posting, and we may fill as Claims Specialist II, Senior Claims Specialist I or Senior Claims Specialist II, depending on candidate experience. The salary range is reflective of this. We are looking to fill the positions in Kent, WA.
- Manages an inventory of claims to evaluate compensability/liability.
- Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
- Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
- Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
- Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
- Performs other duties as assigned.
Primary Location: Kent, WA
Additional Locations: Seattle, WA; Tukwila, WA;
Within the City of Seattle’s Department of Human Resources, the Workers’ Compensation unit is a service-driven team that delivers customer service and proactive claims management. This unit is responsible for administering the City’s self-insured workers’ compensation program. We are looking for a Workers’ Compensation Analyst to adjudicate and effectively manage workers’ compensation claims.
You will be prepared for this role if you have experience or certification in:
- Washington State workers’ compensation claims handling and management, including pertinent guidelines and laws. Experience in a self-insured environment is highly beneficial
- Reading and interpreting medical terminology and the Washington Labor and Industries Medical Treatment Guidelines
- Communicating with a wide variety of people and perspectives, including in situations that require confidently defending your decision-making
- Calculating and assigning timely and appropriate reserves to claims; managing reserve adequacy through the life of the claim based on ultimate probable outcome
- Managing claim recoveries, including but not limited to subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets
- Washington Workers’ Compensation Professional designation (WWCP) is beneficial
- Certified Claims Administrator (through Washington State L&I) is beneficial
- A Bachelor’s Degree in Business or Public Administration, Legal, Medical, or a related field
- One year of experience in Washington State workers’ compensation claims management for the Workers’ Compensation Analyst role
- Associate Degree in Business or Public Administration, Legal, Medical, or a related field
- Two years of experience in Washington State workers’ compensation claims management for the Workers’ Compensation Analyst role
- Three years of experience in Washington State workers’ compensation claims management for Workers’ Compensation Analyst role
Educational Service District 112 is recruiting for an Insurance Claims Adjuster – Workers’ Compensation who will adjust, manage, monitor, and handle workers' compensation claims in compliance with the state industrial injury insurance laws and generally accepted claim principles and practices, established policies and procedures. This position is full-time, working 260 days (12 months) per year. The annual salary starts at $69,160.00 ($33.23/hr) with an increase to $70,553.60 ($33.92/hr) starting September 1, 2021. Interested in applying or want to know more? Visit our online posting for a complete list of job functions, qualifications and application.