L&I Medical Treatment Adjudicator 2

Our Mission:Keep Washington Safe and Working!
Our Values: Customer Focus One L&I Respect Diversity Equity and Inclusion Learning and Growth Reliability

Please Note:This is an internal only opportunity for current Labor & Industries employees only.

Do you want to use your excellent communication and customer service skills to provide consultation to customers regarding bill payment issues Are you ready to serve as a subject matter expert for billing related issues on a Medical Adjudicator team Do you enjoy coaching and mentoring newly hired staff If this sounds like you consider this opportunity and apply today.

L&Is Insurance Services Health Services Analysis program is seeking a Medical Treatment Adjudicator 2 to report to a Medical Treatment Adjudicator Supervisor within the Medical Bill Payment Unit.

In this position you will serve as a subject matter expert and resource for newly hired Medical Treatment Adjudicator 1s. You will assist with coaching mentoring and training during their 6-month training plan. Additionally you will provide consultative services to internal and external customers such as medical providers workers and/or department and agency staff regarding bill payment issues policies procedures laws and rules. This position directly supports our agencys mission to Keep Washington safe and working by ensuring the timely and accurate adjudication of payments for medical bills and other services.

What we are looking for:

• Strong interpersonal verbal and written communication skills.
• Demonstrated ability to work effectively with other members of a team in a training environment.
• Provide direction and give feedback to others while remaining positive and encouraging.
• Ability to communicate and present complex information to a wide variety of audiences in a way that is easy to understand.
• Detail-oriented and able to develop effectively prioritize and maintain a highly organized work environment.
• Ability to perform multiple tasks with potential interruptions.

Why Work for us:

The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety health and security of Washingtons workers. We help employers meet safety and health standards and inspect workplaces when alerted to hazards. As administrators of the states workers compensation system we are similar to a large insurance company providing medical and limited wage-replacement coverage to workers who suffer job-related injuries and illness. Our rules and enforcement programs help ensure workers are paid what they are owed that children and teens work hours are limited and that consumers are protected from unsound business practices.

Insurance Services is the largest division within the agency and administers one of the premier workers compensation organizations in the nation serving over 3.8 million employees working for 260000 employers.

The Health Services Analysis Program Medical Bill Payment (MIPS) unit provides bill payment adjudicative and consultative services to internal and external customers including medical providers workers and/or department and agency staff.

Some of what you will do:

• Serve as a subject matter expert and resource to assist coach mentor and train newly hired Medical Treatment Adjudicator 1 (MTA 1) staff.
• Advise MTA 1 staff in the adjudication of medical bills containing one or more system edits.
• Review random samples of adjudicated bills from MTA 1s for accuracy through regular quality assurance checks.
• Effectively maintain and assist with unit caseload and accurately adjudicate bills within established time standards.
• Use Journey level knowledge of rules and department policies to manage Resource Mailbox.
• Print batch and delivery of bills for reprocessing in the office. Review all batches for bill types and correct format before delivering to bill processing.
• Resolve complex issues involving multifaceted billing procedures or processes.
• Serve as the bill payment units expert consultant regarding all types of financial transactions related to providers and workers.
• Correspond to written requests via telephone and or in writing regarding financial transactions processed through the bill payment system.
• Process the bill payment units refunds revenue transfers provider self-audits and all other audit transactions.
• Work collaboratively with other MTAs and/or agency areas to assist with developing processes and procedures on handling complex billing issues through use of standard systems.
• And much more!

Required:

• A Bachelors degree.

OR

• One year of experience as a Medical Treatment Adjudicator.
• Completion of two years of college or recognized business school AND two years of experience in claims adjusting claims investigation paramedical occupation or increasingly responsible administrative experience in business or governmental work.

Additional qualifying experience may be substituted year-for-year for education.

Additional medically related education may be substituted year-for-year for experience.

Desired:

• Knowledge of medical billing codes Medical Aid Rules and Fee Schedules RCWs WACs and policies for the purpose of processing medical bills for workers.
• Demonstratedskillofcommunicatingeffectively. Providing clear concise and effective verbal electronic and written communications to both internal and external customers.
• Ability to perform multiple tasks with potential of interruptions.
• Understand and maintain confidentiality standards.

Things You Need To Know

At L&I your voice matters. L&I is a diverse state agency dedicated to the safety health and security of Washingtons 3.3 million workers. Watch this brief video and learn more about why L&I is an employer of choice.

L&I provides a modern work environment and excellent benefits including paid leave tuition reimbursement Infants at Work Program and a generous retirement package for qualified employees at the end of their career. Click on the Benefits tab to learn more.

We value our employees and their work-life balance. We support a hybrid work model and offer flexible custom work schedules. This position is eligible for a flexible schedule (4/10s 9/80s 5/8s etc.) upon approval by management. For positions where in office work is necessary the frequency of telework will be discussed with the supervisor of the position at the time of offer.

For this position teleworking is permitted most of the time. You will be expected to report to the office at least once a week to complete the essential duties of this position as well as when necessary for meetings training or upon business needs. The assigned duty station for this position is Tumwater Washington.

To receive more information on opportunities at L&I sign up for GovDelivery and select L&I job alerts.

Application process

We will contact the top candidates directly to interview for this position. Because we base the selection on information provided by you it is in your best interest to identify the knowledge skills and abilities that address the required and desirable qualifications described in the announcement.

Please include the following documents with your application:

1. A cover letter describing specific qualifications.
2. A current resume detailing applicable experience and education.
3. A list of at least three professional references with current telephone numbers.

Please do not attach or place any medical information (vaccination status included) within the application resume or cover letter. If you do we will have to reject your application to safeguard others from receiving your confidential information. You will have to remove the confidential information before you can apply again.

To learn more about our hiring process timeline at L&I please visit our L&I recruiting page at Hiring Process at L&I. If you would like to read our website in a language other than English scroll up to the top of the page to select your language of choice from the banner.

Background Check Notice

Prior to a placement in this position a background check including criminal history records will be conducted. Information from your background check will not necessarily preclude employment but will be considered in determining your eligibility to perform the requirements of the position.

Other information

• For positions requiring travel you must have a valid unrestricted drivers license and have insurance if driving a privately owned vehicle on state business.
• This position is represented bytheWashington Federation of State Employees (WFSE).
• Candidates who are offered a job with L&I must possess work authorization that does not require sponsorship by the employer for a visa now or in the future.
• The Department of Labor & Industries complies with the employment eligibility verification requirements of the federal employment eligibility verification form I-9. The selected candidate must be able to provide proof of identity and eligibility to work in the United States consistent with the requirements of that form on the first day of employment.
• Please note: L&I may use this announcement to fill multiple permanent and/or non-permanent positions.

Did You Know

Washington is Americas Top State to live play and work according to U.S. News (2021). Join the L&I team and enjoy all the Evergreen State has to offer.

Veterans Preference

Applicants wishing to claim Veterans Preference should attach to their application a copy of their DD-214 (Member 4 copy) NGB 22 or signed verification of service letter from the United States Department of Veterans Affairs. Please blackout any personally identifiable data such as Social Security numbers. For further information contact L&Is .

Diversity Equity and Inclusion Employer

L&I employees come from all walks of life. We strive to hire great people from a wide variety of backgrounds. All qualified applicants will receive consideration for employment without regard to race color religion gender gender identity or expression sexual orientation national origin genetics disability age or veteran status.

We believe in the importance of recognizing the value each of us contributes to the success of the agency mission. Having a diverse workforce is this agencys greatest source of strength and knowledge. It is through the combination of talents and abilities that we can pursue finding effective measures to provide the best customer service. We are committed to building a diverse and inclusive workplace for everyone and we strongly mean everyone.

The State of Washington is an equal opportunity employer. Persons with a disability who need an accommodation in the application process or testing process or those needing this announcement in an alternative format may call . TTY users should first call 711 to access the Washington Relay Service.

You are welcome to include the name and pronoun you would like to be referred to in your materials and we will honor this as you interact with our award-winning diverse and inclusive organization.

For more Information

If you have any questions regarding this job posting program or the agency please contact Angela Laramie at.
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