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The Seattle Department of Human Resources (SHR) endeavors to promote an equitable and engaging work environment so City of Seattle employees can do their best work and make a difference for the people and communities we serve. SHR focuses on providing high quality services to all City employees and departments and works collaboratively with department leaders to align policies, practices, and programs citywide to fulfill the vision of equity and excellence.
Within the department, the Workers’ Compensation unit delivers customer service and proactive claims management to City employees. This unit is responsible for administering the City’s self-insured and self-administered workers’ compensation program with a human centered focus. We are looking for a compassionate and capable Worker’s Compensation Analyst to adjudicate and effectively manage workers’ compensation claims.
The work of this position requires a hybrid combination of in-office and telework. Additional occasional onsite work and meetings may be required, as dictated by business needs.
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, laws and rules
- Adjudicating workers compensation claims through developed action plans, managing timely reserve adequacy throughout the life of the claim
- Reading and interpreting medical terminology and the Washington Labor and Industries Medical Treatment Guidelines
- Calculating and paying timely benefits as owed, approving timely claim payments and adjustments
- Communicating with a wide variety of people and perspectives, including in situations that require confidently upholding your decision-making
- Managing claim recoveries, including but not limited to subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets
- Prepare claims for litigation, including providing testimony as requested, in consultation with the City Attorney Office and unit supervisor
- Certified Claims Administrator (through Washington Department of Labor and Industries)
- Washington Workers’ Compensation Professional designation (WWCP) preferred
The Workers Compensation Claims Specialist works within a Claims Team, using the latest technology to manage an assigned caseload of routine to mild to moderately complex Workers Compensation claims from the investigation of the claim through resolution. This includes making decisions about liability/compensability, evaluating losses, and negotiating settlements. The role interacts with injured workers, claimants, policyholders, medical providers, attorneys, and other third parties throughout the claims management process. The position offers training developed with an emphasis on enhancing skills needed to help provide exceptional service to our customers.
Washington Self-Insured Certification Preferred.
- Manages an inventory of workers compensation 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 compensability.
- 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.
- Assesses and conducts negotiations, within assigned authority limits, to settle claims.
- Performs other duties as assigned.
- 1-5 years' experience in claims adjusting along with knowledge of claims investigation techniques, legal liability, insurance coverage, negotiation skills and medical terminology
- Effective written and verbal communication skills to provide information in a clear and concise manner and to communicate with a variety of individuals
- Effective analytical skills to gather information, analyze facts and make recommendations based upon information collected
- Required to obtain and maintain all applicable licenses. Continuing education courses leading to industry certifications preferred (e.g., AEI, IIA, CPCU).
Assistant City Attorney, Workers Compensation (Seattle City Attorney’s Office)
$99,930.00 - $159,697.00 Annually ($47.86 - $76.48 hourly)
The Employment Section of the Seattle City Attorney’s Office plays a critical role in addressing labor and employment issues arising from the City of Seattle’s diverse workforce of over 10,000+ employees across all City departments.
We are seeking an Assistant City Attorney to join the Employment Section to advise and litigate workers’ compensation matters on behalf of the City. This position reports to the Employment Section Director and is supported by a paralegal dedicated to the workers' compensation matters.
Attorneys in the Employment Section take a collaborative, team-oriented approach to litigation and advice work, which is essential for building effective teams and relationships with City Departments and their leadership. Employment attorneys implement the City’s Race and Social Justice Initiative in all aspects of their work.
Effective September 12, 2022, the Seattle City Attorney’s Office will be implementing an Alternative Work Arrangements Policy. Employees will have the option to work a hybrid schedule (2 days in office, 3 days remote). This is subject to change as circumstances dictate.
Responsible for the growth of the revenue base through the sale of new business opportunities while expanding and/or maintaining the existing revenue base.
DUTIES AND RESPONSIBILITIES:
- Manages essential account set-up functions for new clients
- Continually monitors TRISTAR’s service to assigned client accounts
- Provides consultative stewardship reporting to clients; identifying and educating clients on issues and trends impacting programs: providing program recommendations.
- Conducts client visits reviewing client loss experience and general company performance.
- Reviews and identifies areas of potential dissatisfaction prior to renewal meetings.
- Performs client renewal, contract revision, and Client Service Instruction preparation.
- Negotiates changes or improvements to service plan.
- Facilitates the reduction of process barriers, technology constraints, or resource constraints by directing and influencing the activities of other internal departments such as information technology, operations and business development.
- Coordinates client invoicing, audits and accounts receivable follow-up for assigned clients.
- Resolves all major customer service issues.; identification of proactive solutions
- Identifies and solicits cross-selling opportunities.
- Participates in local insurance community through advanced education and affiliation memberships.
- Supervises and directs staff as assigned.
- Responsible for budget preparation and profit and loss on assigned accounts in conjunction with Branch and Regional management.
- Provides broker requests for information.
- Ensures compliance with all applicable Quality initiatives.
- Travel as required.