Claims Officer II

King County   Seattle, WA   Full-time     Administration / Clerical
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Posted on June 3, 2021
Summary

Update: This recruitment will now be used to fill two (2) Career Service positions and one (1) Term-limited Temporary (TLT) position.  The TLT assignment is anticipated to last up to six (6) months.   This recruitment will remain open until filled. Applicants are encouraged to apply as soon as possible.  First review of applications will begin on June 17, 2021. 

The Central Employee Services Division within King County's Department of Human Resources (DHR) seeks customer-focused professionals for three Claims Officer II positions who 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 one of the most influential civil rights leaders in our nation’s history, Martin Luther King, Jr. County is a vibrant international community with residents that represent countries from around the world. It is a region with increasing diversity that cherishes the artistic and social traditions of many cultures.
 
King County has a deep commitment to equity and social justice, and the Claims Officer II has a role in advancing practices to promote inclusion, belonging, and opportunity for all County employees.
 
To learn more, please visit: http://www.kingcounty.gov/elected/executive/equity-social-justice.aspx 
 
Other Position Information 
This position is exempt from the provisions of the Fair Labor Standards Act and is 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.

Job Duties

To be considered for this opportunity, you must at a minimum, demonstrate knowledge, skill, and ability to do:

  • Manage complex Workers' Compensation claims, including investigating, taking statements, calculating time loss payments, reserving, and reviewing medical records to ensure County compliance with relevant laws, administrative orders, and policies and procedures.
  • Communicate with employees in a timely, positive manner to explain benefits and decisions.
  • Initiate and coordinate early return to work, light duty, and alternative work assignments.
  • Assist in coordinating compliance of County offices with Americans with Disabilities Act (ADA) requirements.
  • Interact with physicians, vocational rehabilitation counselors, attorneys, supervisors, administrators, and employees with issues related to Workers' Compensation.
  • Interact and direct the work of external nurse case managers and vocational rehabilitation counselors, including selection and case assignment.
  • Communicate and negotiate with the Washington State Department of Labor and Industries on determinations, allowances, denials, closures, re-openings, and permanent disability awards.
  • Prepare claims for litigation and participate in subrogation matters.
  • Maintain professional knowledge and remain current on all applicable federal, state, and local statutes, codes, and ordinances governing the administration and management of Workers' Compensation.
  • Additional duties as assigned. 

Experience, Qualifications, Knowledge, Skills

Minimum Qualifications

  • Six years of experience managing and processing industrial claims with disability benefits, including vocational rehabilitation OR 
  • A Bachelor's degree with major coursework in business administration, public administration, social sciences, or a closely related field, with two years of experience managing and processing industrial claims with disability benefits, including vocational rehabilitation OR
  • Any equivalent combination of experience and education which provides the applicant with the desired skills, knowledge, and ability required to perform the work.
Other Qualifications
  • Knowledge of state laws, regulations, and relevant court rulings regarding Workers' Compensation; knowledge of standard medical and legal terminology, practices, and procedures; knowledge of investigation and adjudication practices of industrial insurance claims.
  • Ability to quickly and accurately calculate claims related figures.
  • Excellent oral and written communication skills, and the ability to communicate with diverse individuals at all levels, both internally and externally.
  • Demonstrated problem-solving and analytical skills with the ability to manage multiple and shifting priorities to meet deadlines, while working under pressure and considering broad impacts to meet customer service expectations and regulatory deadlines.
  • Demonstrated commitment to deliver courteous, sensitive, and responsive service to all internal and external customers with the ability to act with the utmost integrity in all professional interactions.
  • Intermediate level proficiency with Microsoft Office Suite and demonstrated ability to quickly learn new technology tools.
  • Experience and demonstrated ability to work effectively and collaboratively with individuals from diverse backgrounds, including sensitivity to and knowledge of various ethnic, cultural, and socioeconomic backgrounds.
  • Ability to work both independently and as part of a team.
Necessary Special Requirements
  • A minimum of one-year experience in adjudicating Washington State Workers' Compensation claims AND
  • Certification by the Department of Labor and Industries or the ability to obtain certification within six months of eligibility OR Washington Workers' Compensation Professional certification.
Desirable Qualifications
  • Experience working with Washington State Self Insured employers.

Supplemental Information

 Temporary Telecommuting Requirement 
Part of the work associated with this position will be performed remotely, at least through July 5, 2021, in compliance with King County’s telecommuting mandate. Employees will be provided with a County issued laptop and must maintain a workspace with an internet connection where they can reliably perform work and remain available and responsive during scheduled work hours.  
 
Employees must reside in Washington State and within a reasonable distance of their King County worksite to respond to workplace reporting requirements. There will be situations where the employee is required to report to a County worksite. Please note that when an employee conducts work that is likely to bring them in contact with another individual, safety precautions are required by the department in alignment with the Public Health Directive from the Seattle & King County Public Health Officer.

To support employees working remotely during this time, King County has a robust collection of tools and resources. The individual selected for this opportunity will join an innovative and progressive team. King County is doing its part to reduce the spread of COVID-19 and remains committed to reducing its carbon footprint.  
 
Forbes recently named King County as one of Washington State's best employers.
Together, with leadership and our employees, we're changing the way government delivers service and winning national recognition as a model of excellence. Are you ready to make a difference? Come join the team dedicated to serving one of the nation's best places to live, work and play. 
 
Guided by our "True North", we are making King County a welcoming community where every person can thrive. We value diversity, inclusion and belonging in our workplace and workforce. To reach this goal we are committed to workforce equity. Equitable recruiting, support, and retention is how we will obtain the highest quality workforce in our region; a workforce that shares and will help advance our guiding principles--we are one team; we solve problems; we focus on the customer; we drive for results; we are racially just; we respect all people; we lead the way; and we are responsible stewards. We encourage people of all backgrounds and identities to apply, including Native American and people of color, immigrants, refugees, women, LGBTQ+, people living with disabilities, and veterans.
 
King County is an Equal Employment Opportunity (EEO) Employer
No person is unlawfully excluded from employment opportunities based on race, color, religion, national origin, sex (including gender identity, sexual orientation and pregnancy), age, genetic information, disability, veteran status, or other protected class. Our EEO policy applies to all employment actions, including but not limited to recruitment, hiring, selection for training, promotion, transfer, demotion, layoff, termination, rates of pay or other forms of compensation.
 
To Apply
These positions are open to King County employees and the general public. If you are interested in pursuing these positions, please follow the application instructions carefully. If you need this announcement in an alternate language or format, would like to request accommodation or assistance in the application or assessment process, or if you have questions please contact the recruiter listed on this job announcement.  This recruitment will be used to fill two (2) Career Service positions and one (1) Term-limited Temporary (TLT) position.  The TLT assignment is anticipated to last up to six (6) months and may be filled as a Special Duty Assignment (SDA) or Term-Limited Temporary (TLT) position. 
 

  • SDAs are open to current King County career service or appointed employees who have passed their initial probationary period. 
  • Career Service and TLTs are open to all King County employees and the general public. 
Selection Process
Applications will be reviewed as received, and they will be screened for clarity, completeness, and competitiveness. All materials will be evaluated for spelling, grammar, and punctuation usage. The most competitive candidates may be invited to participate in a series of interviews. Reference checks and/or record reviews will also be conducted.
 
Forms and Materials Required 
  1. An online employment application completed at www.kingcounty.gov/jobs. The employment history should go back at least 10 years if you have 10 years of employment (or more to include all relevant experience). 
  2. A cover letter no more than two pages summarizing how you meet the required qualifications, knowledge, and skills for the job.
For more information regarding this recruitment, please contact:
Jen Montoya, Senior HR Analyst
206-477-5997
jen.montoya@kingcounty.gov

King County offers a highly-competitive compensation and benefits package designed to meet the diverse needs of our employees and support our employees' health and well-being.  Eligible positions receive the following benefits and have access to the following programs:

  • Medical, dental, and vision coverage: King County pays 100% of the premiums for eligible employees and family members
  • Life and disability insurance: employees are provided basic coverage and given the opportunity to purchase additional insurance for both the employee and eligible dependents
  • Retirement: King County employees are eligible to participate in a pension plan through the Washington State Department of Retirement Systems and a 457(b) deferred-compensation plan
  • Transportation program and ORCA transit pass
  • 10 paid holidays each year (plus 2 personal holidays)
  • Generous vacation and paid sick leave
  • Paid parental leave, family and medical leaves, and volunteer leave
  • Flexible Spending Account
  • Wellness programs
  • Onsite gyms and activity centers
  • Employee giving program
  • Employee assistance programs
  • Flexible schedules and telecommuting options, depending on position
  • Training and career development programs
For additional information about employee benefits please visit our Benefits, Payroll, and Retirement Page.

This is a general description of the benefits offered to eligible King County employees, and every effort has been made to ensure its accuracy.  If any information on this document conflicts with the provisions of a collective bargaining agreement (CBA), the CBA prevails.  Also, in the event of any incorrect information in this document, applicable laws, policies, rules, CBAs, or official plan documents will prevail.
 
NOTE:  Benefits for Term Limited Temporary (TLT) or Short Term Temporary (STT) positions, including leave eligibility and/or participation in the pension plan through the Washington State Department of Retirement Systems, will vary based upon the terms and details of the position. Short Term Temporary positions are not eligible for an ORCA transit pass.
 
For inquiries about the specifics of this position, please contact the recruiter identified on this job posting.

01
How many years of experience do you have managing and processing industrial insurance claims?
  • No experience to less than two years
  • Two or more years, but less than four years
  • Four or more years, but less than six years
  • Six or more years
02
How many years of experience do you have adjudicating workers' compensation claims in Washington State?
  • No experience to less than one year
  • One year, but less than two years
  • Two or more years, but less than four years
  • Four or more years, but less than six years
  • Six or more years
03
How many years of experience do you have adjudicating self-insured workers' compensation claims?
  • No experience to less than one year
  • One year, but less than two years
  • Two or more years, but less than four years
  • Four or more years, but less than six years
  • Six or more years
04
What is the highest level of education you have completed?
  • High School or GED
  • Some college
  • Associate's degree
  • Bachelor's degree
  • Master's or other advanced degree
05
Do you currently have a Washington Workers' Compensation Professional certification?
  • Yes
  • No
06
Do you currently have a Department of Labor and Industries Certification?
  • Yes
  • No
07
Which statements best describe your experience managing and processing Workers' Compensation claims?
  • I investigated and adjudicated industrial insurance claims
  • I took statements from claimants, witnesses, and other interested parties
  • I estimated the cost of claims
  • I reviewed medical records
  • I ensured compliance with relevant laws, policies, and procedures
  • I helped injured employees understand their benefits and the status of their claims
  • I coordinated return to work, light duty, and alternative work assignments for injured employees
  • I worked with physicians, vocational rehabilitation counselors, supervisors, attorneys, and employees on issues related to workers' compensation
  • I communicated and negotiated with the Washington State Department of Labor & Industries on determinations, allowances, denials, and closures
  • I communicated and negotiated with the Washington State Department of Labor & Industries on permanent disability awards
  • I prepared claims for litigation and represented my employer in subrogation matters
  • I processed medical only claims
  • I processed active time loss claims
08
Are you applying to this position as an eligible Current or Previous King County Employee Priority Placement Program Participant AND Is this position the same or lower percentage of full-time when compared to the position held at the point of the notification of layoff AND Do you possess the skills and abilities to qualify for this position?
  • Yes, I was given a layoff notice from my role at King County AND I am within two years of the effective date of my layoff. AND The position I was laid off from was the same or a higher percentage of FT status when compared to this one.
  • No.
09
If you answered yes to the question above and you are applying for this position as a Priority Placement Participant, to be considered, you must provide the following three pieces of information in the space provided: 1. The title you held when you received your layoff notice 2. The department you worked in 3. The effective date of your layoff

Required Question