Job Highlights

Please Note: This announcement represents multiple permanent opportunities.

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The Department of Labor & Industries (L&I) is a diverse state agency dedicated to the safety, health, and security of Washington's workers. We help employers meet safety and health standards and inspect workplaces when alerted to hazards. As administrators of the state's 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 also help ensure workers are paid what they are owed, that children's 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 260,000 employers.

Within Insurance Services, the Health Services Analysis team is responsible for ensuring that medical services are paid appropriately.

L&I's Insurance Services' Health Services Analysis program is seeking multiple Medical Treatment Adjudicator 2's to report to a Medical Treatment Adjudicator Supervisor within the Medical Bill Payment Unit. As a Medical Treatment Adjudicator 2 In-Training within the Medical Bill Payment and Provider Hotline Program, you will learn how to adjudicate medical billings and process payments for medical services provided to injured workers through an assigned caseload. This opportunity will help you in gaining valuable knowledge in a phone center environment where you will be in contact with providers, injured workers and billers. 

Please Note:  This position is considered in-training.  If hired, you will be hired at the Medical Treatment Adjudicator 1 (MTA1) level and receive up to 18 months of training.  After successfully completing the training plan requirements, you'll advance to the level of Medical Treatment Adjudicator 2 (MTA2).  The salary ranges for each job classification are as follows:

The salary range for each job classification is as follows:

• L&I Medical Treatment Adjudicator 1: $3,477 to $4,632 (monthly)

• L&I Medical Treatment Adjudicator 2: $3,728 to $4,987 (monthly)

   

   

   

Duties:

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Some of what you'll do:

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• Answer customer inquiries presented by an automated call distribution system or secure email transition.
• Provide understandable explanations of department policies and processes to customers in an effort to assist with accurate bill submission.
• Authorize or deny treatment authorization requests in accordance with department rules and policies.
• Respond to written requests for authorization of hearing aid repairs/replacements, continuing physical, occupational, and massage therapy services, and durable medicine requests.
• Research claim files to determine claim status, allowed diagnosis, attending physicians, recent surgeries & number of treatments to date in current therapy period, and history of hearing aid repairs.
• Advise claim managers of treatment authorization requests and potential problems related to claim management or treatment.
• Advise and assist other medical treatment adjudicators in the adjustment and payment of medical bills when adjudication errors result in incorrect payment or denial of services.
• And much more!!

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