Claims Adjudicator

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JOB TITLE:               Unemployment

                                Claims Adjudicator                                          FLSA STATUS:         Non-Exempt

DEPARTMENT:        Claim Services                                              

REPORTS TO:          Director of Safety and Claim Services

PAY RANGE: $68,000 to $88,000

HYBRID WORK OPPORTUNITY AVAILABLE

POSITION SUMMARY:   

The Unemployment Claims Adjudicator position provides unemployment claim adjudication in support of the Washington Hospital Services (WHS)/United Claims Management unemployment program.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Maintain the accuracy and confidentiality of data, records, and files.  
  • Process paperwork and routine information requests; monitor timely receipt of information from clients and Employment Security Department (ESD).
  • Create added-value enhancements to the program and streamline claims processes.
  • Act as a lay legal representative for employer clients before the ESD, Office of Administrative Hearings, Commissioner’s Review Office, and the District Tax Office. 
  • Identify and prepare key witnesses, select and submit evidentiary documentation, make necessary objections, and make oral argument before the Administrative Law Judge (ALJ) for unemployment eligibility hearings. 
  • Write arguments to persuade the commissioner to affirm or reverse the ALJ’s order, for petitions for review. 
  • Compile documents for review, file appeals and withdrawals, schedule hearings, request postponements, manage the hearing calendar, and perform other administrative tasks.
  • Identify and investigate potential separation and availability issues affecting claimant eligibility for unemployment benefits.
  • Request information from and provide information to both the Employment Security Department and clients.
  • Research and review current laws and decisions to expand knowledge base.
  • Request, collect, and analyze quarterly wage reports from clients; troubleshoot and resolve account concerns between the client and the tax office.
  • Request, collect, and analyze benefit charge reports from clients; assist Director with benefit charge questions.
  • Produce quarterly correspondence, charts, reports, and forms for clients using word processing, database, spreadsheet, and graphics software.
  • Establish positive and professional working relationships with clients and external contacts.
  • Research and answer client questions on unemployment issues within scope of authority and ability while maintaining a high degree of professionalism and customer service.
  • Represent the organization at client meetings, professional association meetings and workshops, and in all business dealings.
  • Assist in the marketing and presentation of unemployment services to potential clients and in the onboarding process of new clients.
  • Supports Workers Comp Program or Claims Assistant as needed.
  • Perform other duties as assigned.

SUPERVISORY RESPONSIBILITIES:  

This position has no supervisory responsibilities.

QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required. 

Education/Experience:   

Bachelor’s Degree or equivalent work experience in human resources or working knowledge of state and federal employment laws, or equivalent combination of education and experience.

Skills & Abilities: 

  • Knowledge or experience working with unemployment laws and claims
  • Demonstrated planning, management and communications skills
  • Must be a self-starter and innovator
  • Ability to work independently
  • Must possess strong analytical and organizational skills
  • Comfortable giving and receiving feedback in a constructive manner to colleagues and supervisors

Computer Skills:

Proficiency with Microsoft Office Suite including Outlook, Word, and Excel required.  Proficiency with email required.   

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

The physical demands and work environment described below represent the activities and surroundings of the positions.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work is typically performed in an office environment, with a moderate noise level.  The position requires working in an office environment with the usual office equipment, including copiers, fax machines, and computers. The employee is frequently required to talk and hear on the telephone and in person with individuals and groups.  The incumbent may carry materials/equipment weighing up to 25 lbs on occasion.  The incumbent is required to read and respond to documents in hard copy and electronic form.  The position requires frequent or occasional travel within Washington State to member facilities, and on occasion, overnight travel is necessitated.

Affiliates

Contact Us

Washington State Hospital Association
999 Third Avenue
Suite 1400
Seattle, WA 98104

Map / Directions

206.281.7211 phone
206.283.6122 fax

info@wsha.org

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