Washington State L&I Medical Treatment Adjudicator 2 - Bill Payer (Crime Victims) in Tumwater, Washington


This opportunity is open to L&I; employees only.

This Medical Treatment Adjudicator (MTA) – Bill Payer opportunity is located in the Crime Victims Compensation Program. As a MTA in the Crime Victims Program you will review, authorize or deny billings from providers treating or rendering services to crime victims. In addition you will authorizes treatment related to the accepted crime injury. Treatment authorization includes, but is not limited to: Dental services; durable medical equipment; medical supplies; physical and massage therapy and replacement of orthotics/prosthetics.

Some of what you will do:

  • Determines extent and availability of primary insurance, researches and resolves conflicting eligibility information.
  • Review and interprets Explanation of Benefits (EOBs) from private/public insurance companies.
  • Supervise and direct the authorization of medical treatment bills and claim adjudication (validity) for sexual assault claims and physical abuse claims.
  • Receive and initiate telephone calls to providers, victims attorneys, collection companies, public and private insurance companies.
  • Respond to billing inquires and researching complex bill/payment issues.
  • Enter collateral resource information into the appropriate subsystem files.
  • Adjudicate bills based on claimant eligibility and validity of service, reviews ICD-9 diagnosis codes, procedure codes and descriptions of service for appropriateness.
  • Process adjustments/deductions of processed bills and resolve complex system edits on billing transactions.
  • Authorize or deny requests for rental/purchase of durable medical equipment and eye glass replacement as appropriate.
  • Review and respond to written payment protests from providers and processes corrections to original adjudicative decisions when necessary.

Who should apply L&I; employees with the ability to work effectively with victims of violent crimes, customers, and in a team setting, support the organization, share information, accept constructive feedback, and contribute to the overall productivity of the unit.

Here is what we are looking for:

  • A minimum of one year experience as a Medical Treatment Adjudicator 1 or three years' experience working in the Crime Victims Compensation Program.
  • Must be willing to work with victims of violent crimes, reading police reports and other related information, this information is sometimes graphic in nature.
  • Excellent customer service, listen attentively, recognize and identify issues, provide options and fulfill services.
  • Typing speed of 25 wpm, including reduction for errors.
  • Use personal computers and software, i.e. MS Word and EXCEL for entering data, editing and formatting audit reports and letters.
  • Skilled in the accurate use of ten-key, entering numerical data by touch.
  • Dependable, punctual, and good attendance are essential to this position.
  • Ability to independently manage time and prioritize work without waiting for supervisor direction, yet recognize when supervisor direction is needed.
  • Clear, concise and professional verbal and written communication in person and in writing.
  • Participate as a positive team member and promote a healthy work environment
  • Demonstrated ability to resolve issues expeditiously and accurately, applying critical reasoning and analytical skills in making sound decisions.
  • Receptive to change and adaptable to new situations and processes.
  • Skilled at responding to difficult, stressful or sensitive interpersonal situations with tact and diplomacy.

Note: The application process requires that you include a letter of interest/cover letter clearly demonstrating how you meet the knowledge, skills, abilities and experience outlined in the job posting.

Supplemental Information

This job announcement may be used to fill multiple vacancies. Application review starts immediately and the hiring authority reserves the right to offer the job at any time. It's to your advantage to apply quickly.

Employees driving on state business must have a valid driver's license. Employees driving a privately owned vehicle on state business must have liability insurance on the privately owned vehicle.

Prior to any new hire into L&I;, a background check, including criminal record history, will be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the position.

To apply, follow the "Apply" link above Jobs advertised as Open Continuous will be closed without notice. Apply quickly!

We're looking for evidence that you have what we're looking for. Your application materials will be used for deciding who'll be selected for interview.

For more information about the Department of Labor & Industries visit: http://www.lni.wa.gov/ OR Contact us at: Jobs@Lni.wa.gov

L&I; strives to attract and retain a high-performing and diverse workforce in which our differences are respected and valued to better meet the needs of the diverse customers we serve. L&I; fosters an inclusive environment that promotes safety, collaboration, flexibility and fairness so that all employees can participate and contribute to their full potential.

This position is represented by the Washington Federation of State Employees (WFSE). That means that, as a condition of employment, no later than the 30th day following the beginning of your employment, you must pay the *WFSE *either membership dues, a representation fee or, for bona fide religious non-associators an amount equal to dues to be used in a program within the union in harmony with the employee's conscience.

Persons with a disability, who need assistance in the application process, or those needing this announcement in an alternative format, may call (360) 902-5700. Applicants that are deaf or hard of hearing may call through the Washington Relay Service at 7-1-1.

The State of Washington is an Equal Opportunity Employer

Salary: $3,054.00 - $3,985.00 Monthly

Location: Thurston County – Tumwater, WA

Job Type: Agency Internal - Permanent

Department: Dept. of Labor & Industries

Job Number: 2017-09351

Closing: 10/18/2017 11:59 PM Pacific

Agency: State of Washington

Address: View Job Posting for Agency Information View Job Posting for Location, Washington, 98504.

Phone: View Posting for Agency Contact

Website: http://www.careers.wa.gov