L&I Workers' Compensation Adjudicator 5

Our Mission: Keep Washington Safe and Working!

Our Values: Customer Focus, One L&I, Respect, Diversity, Equity and Inclusion, Learning and Growth, Reliability

This position is open to L&I employees only.

About the role

The Department of Labor and Industries’ Self-Insurance Program is seeking a Workers’ Compensation Adjudicator 5 (WCA5) to join our team. You’ll support the agency’s mission by assessing and enforcing compliance of the RCWs and WACs governing Self-Insured Employers and Third-Party Administrators’ administering workers’ compensation benefits to employees injured on the job. This opportunity will require reviewing recommendations from internal and external parties to determine appropriateness of the assessment or denial of penalty against Self-Insured employers per statutes and rules.

L&I's Self-Insurance Program is dedicated to supporting employers and protecting workers by providing impartial oversight and timely, expert services to the self-insured community.

Responsibilities

• Interprets facts and applies laws and rules when determining assessments of penalties on violations.
• Manages a caseload of work item requests by reviewing, adjudicating and assuring decisions are made within management expectations.
• Assigns, tracks, and reviews recommendations from level 3, 4 and 5 adjudicators.
• Reviews requests for Willful Misrepresentation sent to the department by Self-Insured employers.
• Testify on facts regarding department actions for all penalty appeals at the Board of Industrial Insurance Appeals (BIIA).
• Give depositions on penalty decisions for specific claims.
• Communicate at other judicially related activities as related to adjudicative level claim decisions.
• Occasionally speak publicly regarding penalties and related compliance activities.
• Participate in legislative activities including bill analyses and rule-making.

Requirements

• Successful completion of the Department of Labor and Industries Workers’ Compensation Adjudicator 2 Apprenticeship program AND one year of experience as a Workers’ Compensation Adjudicator 4.
• Bachelor’s degree AND four years of experience in adjudicating workers’ or crime victims’ compensation insurance claims, or adjudication of time loss payments.
• 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.

Qualifications

• Four years of experience in adjudication of workers’ claims with the Department of Labor and Industries, to include one year of experience as a Workers’ Compensation Adjudicator 4.
• Professional designation as a Self-Insurance Certified Claims Administrator or the ability to obtain the certification within 6 months.
• Experience working in the Self-Insurance Program and with self-insurance rules and regulations.
• Experience in overseeing or managing self-insured claims in Washington State.

Benefits

• Teleworking and flexible custom work schedules.
• Generous retirement package for eligible state employees.

At L&I, your voice matters. The agency is dedicated to the safety, health, and security of Washington's 3.8 million workers and values a diverse and inclusive workplace.

Schedule

For this position, telework is dependent on business needs and supervisor approval. The assigned duty station for this position is Tumwater, Washington. For positions where in-office work is necessary, the frequency of telework will be discussed with the supervisor at the time of offer.