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The Central Employee Services Division within King County's Department of Human Resources (DHR) seeks customer-focused professionals for two Claims Officer II positions. They will adjudicate Workers' Compensation claims in accordance with the legal requirements of the industrial insurance laws and the claims management standards of King County. As a self-insured entity in Washington State, King County self-administers its Workers’ Compensation program. As one team, the Central Employee Services Division supports a thriving King County employment experience and provides integrated compensation, benefits, work/life well-being, safety, and retirement planning services. Ensuring the health and safety of employees is our number one priority.
Commitment to Equity & Social Justice
As the only county in the United States named after Dr. Martin Luther King, Jr., one of the most influential civil rights leaders in our nation’s history, King County is a vibrant international community with residents that represent countries from around the world. It is a diverse region that cherishes the artistic and social traditions of many cultures. King County has a deep commitment to equity and social justice. Applying equity and social justice principles is a daily responsibility and a foundational expectation for all King County employees. The Claims Officer II will apply equity and social justice principles that exemplify shared values, behaviors, and practices in all aspects of the work.
To learn more, please visit: http://www.kingcounty.gov/elected/executive/equity-social-justice.aspx
Other Position Information
These positions are exempt from the provisions of the Fair Labor Standards Act and are therefore not overtime-eligible. Employees are paid on a bi-weekly schedule, every other Thursday, comprising a 40-hour workweek, normally 8:00 a.m. - 5:00 p.m., Monday through Friday. These positions are represented by Teamsters Local 117/Professional & Technical. The work associated with these positions will be performed predominately through a hybrid work schedule of onsite and remote work.
Applications will be screened for qualifications throughout the posting period. Applicants who meet the necessary qualifications and who are the most competitive based on their knowledge, skills, abilities and experience will be invited to interview during the following weeks:
- Applications received November 4 - December 9 will be screened with successful candidates invited to interview on December 15.
- Applications received December 10 - January 20 will be screened with successful candidates invited to interview on January 26.
- Applications received January 21 - March 5 will be screened with successful candidates invited to interview on March 16.
The Workers Compensation Sr 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 and evaluating losses. The role interacts with injured workers, self-insured employers, 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 statutory compensability for submitted claims and notifies the self- insured employer of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim.
- Performs other duties as assigned.
Primary Location: Remote
Additional Locations: Tacoma, WA; Liberty Lake, WA; Bellingham, WA; Kent, WA; Vancouver, WA;
Schedule: Full-Time Salary: USD-$71,400.00-–-$100,300.00-/-Year
Travel: As Needed
Reports To: Assistant Superintendent, Finance and Operations
Classification: Exempt 1.0 FTE / (Mon-Friday / 8 hours per day)
Starting Salary: $80,707.50
SUMMARY: Supports the development and implementation of safety and health programs in conjunction with loss control services for the member districts of the ESD 123 Workers’ Compensation Trust. Assist member districts with reducing workers’ compensation losses and loss control compliance program activities. Aid member districts’ compliance with WISHA and OSHA requirements.
- Analyze workers compensation claims and data and recommend action for 19 member districts to reduce losses.
- Provides information, consultation and assistance on risk management issues including but not limited to WISHA requirements; worker safety; and hazardous materials.
- Assist districts with ergonomic assessments.
- Conduct research for and respond to phone inquiries and other requests for information regarding loss control and related topics.
- Organize and provide training on WISHA loss control issues for district employees and administrators.
- Prepare written reports and correspondence.
- Conduct safety walkthroughs throughout member districts and provide recommended actions to help improve safety and reduce losses.
- Develop and initiate risk management, safety and loss control programs for member districts and provide, or arrange for and oversee, regional and district risk management, safety, and loss control training for member districts.
- Attend district and ESD 123 safety committee meetings when appropriate.
- Establish and maintain WISHA loss prevention training programs for member districts.
- Maintain a working knowledge of safety rules and regulation related to ESD’s and school districts.
- Review employee incident report and worker compensation claims for potential loss control action
- Manage and maintain the online safety training platform for ESD 123 and consortium districts. This includes and is not limited to providing support to district staff for system setup, maintaining updated data, assigning courses, tracking completions etc.
- Seek and take advantage of opportunities for professional growth.
- Collaborate within the agency and with school systems for the success of the department and ESD.
- Be an active member of the ESD Trust and attend meetings and trainings as offered.
- Organize and provide First Aid/CPR training and certification, if credentialed, to ESD 123 and district staff as requested.
Are you looking for an opportunity to join a claims team with a fast growing company that has consistently outpaced the industry in year over year growth? Liberty Mutual Insurance has an excellent claims opportunity available for a Workers Compensation Claims Technician (Medical Only). Claims Technicians obtain essential information in order to process routine workers’ compensation (WC) claims with on-going medical management for medical pension claims. Provides injured workers and customers with accurate, timely information and quality service. Claims Technicians also identity potential problems and makes claim referral decisions.
*This position may be filled as a Workers Compensation Claims Technician or Workers Compensation Senior Claims Technician.*The salary range posted reflects the range for the varying pay scale that encompasses each of the Liberty Mutual regions and the overall cost of living for that region.
GRS North America Claims is excited to announce our go forward strategy to provide employees with the flexibility to include an option to work from home full-time. Candidates who are selected for this position will be trained remotely and should reside within a reasonable commute of our Rocklin, CA office.
- Conduct investigation to secure essential facts from injured worker, employer and providers regarding workers’ compensations through telephone or written reports. Verifies information from claimants, physicians, and medical providers to assess compensability and/or causal relation of medical treatment, and make evaluations for cases with claim specific on-going medical management.
- Provides on-going medical case management for assigned claims. Initiates calls to injured worker and medical provider if projected disability exceeds maximum triage model projection or to resolve medical treatment issues as needed. Maintains contact with injured worker, provider and employer to ensure understanding of protocols and claims processing and medical treatment.
- Continually assesses claim status to determine if problem cases or those exceeding protocols should be referred to Claims Service Team and/or would benefit from, MP RN review or other medical /claims resources. Arranges Independent Medical Exam and Peer Review as necessary.
- Maintains accurate records and handles administrative responsibilities associated with processing and payment of claims. Records and updates status notes; documents results of contacts, relevant medical reports, and duration information per file posting standards including making appropriate medical information viewable to customers in Electronic Document Management (EDM). Generates form letters following set guidelines (i.e., letters to physicians projecting disability, letters confirming medical treatment and disability and letters outlining expected outcome to employers).
- Authorizes payment of medical payments and/or medical treatment.
- Recognizes potential subrogation cases, prepares cases for subrogation and refers these cases to the Subrogation Units.
Primary Location: Portland, OR
Additional Locations: Seattle, WA;
Travel: As Needed