Claims Team Lead

King County
$100,573 - $127,482 Per year WA King County Human Resources Division, 500 4th Ave #553, Seattle, WA 98104, United States Apply before 5/27/2024 11:59


This opportunity is a Special Duty Assignment (SDA), open to current Career Service King County employees who have completed their initial probation ONLY. This SDA is anticipated to end December 31, 2024
The Central Employee Services Division within King County's Department of Human Resources (DHR) seeks a seasoned Workers’ Compensation Claims expert to fill a key role in the day-to-day operations of the Safety and Claims Section.  
Reporting to the Safety and Claims Manager, the (Project/Program Manager III) will be the technical expert in claims management and will manage the more complex cases. The successful candidate will be responsible for database and claims management, staff and project development, and serve as lead for the Claims Officer II staff.
This role requires outstanding interpersonal, team building, and communication skills; and a deep knowledge of and experience with the professional and regulatory workers’ compensation environment in Washington state.
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.

Job Duties

Applying (ESJ) is a daily responsibility and a foundational expectation for all King County employees. This role will champion King County’s deep commitment to ESJ by exemplifying shared values, behaviors, and practices in all aspects of the work.  

  • Serve as a technical expert and team lead within the unit. Provide leadership, technical assistance, and training to staff and partners on best practices in claims management.
  • Perform general audit functions of claims in iComp (Claims Processing system) for quality assurance and continuously monitor the quality and efficiency of the claims adjudication process.  
  • Assist Claims Manager and Claims Supervisor with policy recommendations and creating standard operating procedures for the claims adjudication processes.
  • Assist Claims Manager and Claims Supervisor with the development and facilitation of training and education of supervisors and employees on workers’ compensation policies and processes, through written materials and presentations. 
  • Assist Claims Manager and Claims Supervisor in coordinating, monitoring, and tracking analytical and statistical information related to workers’ compensation and the production of relevant reports and recommendations.  
  • Manage all data gathering for performance reviews, conduct claim reviews and audits, and review penalties. Provide performance evaluation input for program staff to Claims Manager and Claims Supervisor. 
  • Propose scope of work and goals for ad hoc assignments or projects for Claims Team. Perform data collection and conduct analyses for assigned research projects; prepare summary reports of analyses and presentation of findings. 
  • Provide, lead or conduct required analyses, including compliance with all relevant laws and regulations that affect workers’ compensation administration. Evaluate new regulations, laws and legislation for impact on services and program goals. Develop and/or modify existing processes for new regulations, laws and legislation with Claims Manager and Claims Supervisor.  
  • Manage a caseload of complex workers’ compensation claims to closure or settlement. 
  • Resolve concerns and issues from injured workers, attorney representatives, regulators and other partners that interact with the workers compensation program.    
  • Serve as a subject matter expert on third party issues, payroll systems, and time loss calculations and processing.
  • Other 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
  • Experience in directing the work of others with the ability to lead, mentor, and coach staff members to work cooperatively and effectively.  
  • Possess strong negotiation and communication skills. Be able to manage diverse and potentially conflicting stakeholder perspectives and backgrounds.
  • Experience developing and presenting training information, using handouts, materials, visual aids, and other tools for group and one-on-one instruction in person or via online platforms. 
  • Experience with database management and creating reports; coordinating, monitoring, and tracking analytical and statistical information. 
  • 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 calculate claims related figures quickly and accurately.
  • 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 data management software 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.
Necessary Special Requirements
  • A minimum of one-year experience in adjudicating Washington State Workers' Compensation claims AND 
  • Claims Administration Certification by the Washington State Department of Labor and Industries OR Washington Workers' Compensation Professional certification.
Desirable Qualifications
  • Experience working with Washington State Self Insured employers.

Other Position Information 
This position is exempt from the provisions of the Fair Labor Standards Act and is 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. This position is represented by Teamsters Local 117/Professional & Technical and is classified as Project/ Program Manager III (job code 243304).

Teleworking Requirement 
The work associated with this position will be performed through a combination of teleworking and two days onsite during the work week. King County employees must reside in Washington State and within a reasonable distance to worksites to respond to workplace reporting requirements.

Supplemental Information

Selection Process
This recruitment is open to current King County employees who passed their initial six-month probationary period. We value diversity, diverse perspectives and life experience and encourage people of all backgrounds to apply. The duration of this Special Duty Assignment is anticipated to end December 31, 2024. The most competitive candidates may be invited to participate in an interview process.

Forms and Materials Required 

  1. An online employment application and answers to the Supplemental Questions completed at . 

For more information regarding this recruitment, please contact:
Jen Montoya
Senior HR Analyst

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To Apply

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