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LCD Hearings Specialist - PFML (BS3): Telework

  • ... Washington State
  • ... Thurston County, Texas, United States
  • ... Full time
  • ... Salary: 76188 per year
  • Posted on: Feb 02, 2024

LCD Hearings Specialist - PFML (BS3): Telework   

JOB TITLE:

LCD Hearings Specialist - PFML (BS3): Telework

JOB TYPE:

Full-time

JOB LOCATION:

Thurston County Texas United States

No

JOB DESCRIPTION:

Description

The ideal candidate will be knowledgeable and experienced in matters related to Paid Family Medical Leave (PFML) and processes to determine eligibility, and the adjudication process. You will be a member of the LCD Compliance Unit and report to the Administrative Hearings Supervisor. Coordinating, planning, developing, reviewing, and revising decisions and case actions regarding PFML benefits.
In this critical role you will ensure that we are meeting ESD's objectives of being good stewards of public resources by ensuring the Paid Family and Medical Leave (PFML) and Long-Term Services and Support (LTSS) trust funds have the appropriate compliance and enforcement activities surrounding them so that the programs have the necessary funding to provide benefits to Washingtonians. You will examine and research PFML-appeals made by claimants and employers, and serve as a liaison between ESD, the Attorney General Office (AGO), and the Office of Administrative Hearings (OAH) ensuring ESD decision are consistent with the AGO and OAH interpretation of Washington Administrative Code (WAC) and Revised Code of Washington (RCW). This position is a full-time/permanent Hearings Specialist and reports to the Administrative Hearings Supervisor.

Duties

A Hearings Specialist's primary responsibility is to review appeals requests, take action, and represent ESD through the adjudicative procedures. Reviewing and researching escalated claimant grievance for PFML benefits, reviewing submitted appeals for validity, and determining if proper data gathering and verification techniques were adequately documented. You are required to represent ESD at a hearing.

Some of what you will do:
  • Determine and design appeal processing schedule and guidelines on case-by-case basis.
  • Monitors, tracks, and reports on highly sensitive claimant and employers appeals as determined by caseworker.
  • Identifies and assembles documents to be used as hearings exhibits.
  • Represents the ESD through the adjudication process and take actions based on hearing outcomes.
  • Oversees the preparation of appeal summaries, correspondence and documents information for tracking/trending data.
  • Be a witness to testify at hearings.
For a full description of duties, please click here to request from recruiter:

Qualifications

Required:
A combination of experience and education equivalent to seven (7) years which includes a minimum of three (3) years of demonstrated experience in two or more of the following areas:
  • Conducting research
  • Analyzing policies, laws, rules, or regulations
  • Conducting business analysis and developing requirements
  • Leading business projects
  • Managing business operations
  • Business policy development
  • Administrating appeals
  • Adjudicating insurance claims and/or benefit applications
Preferred:
  • Experience working with appeals.
  • Knowledge of PFML rules, laws, regulations, and policies.
  • Completion of a paralegal program or experience working as a paralegal.
Additional Requirement of Employment:
  • Must be able to pass an Unemployment Insurance (UI) Claim & Benefit Information Review.
Please submit only the required documents as noted below and ensure all Personal Identifying Information (PII) such as Social Security numbers etc. are edited out of your materials for privacy.

Attach your Cover Letter, and Resume with your through the \\\\\\\\\\\\\\\"Add Attachments\\\\\\\\\\\\\\\" field. A resume will not substitute for the \\\\\\\\\\\\\\\"work experience\\\\\\\\\\\\\\\" section of the application or vice versa. Applications with blank fields, or supplemental question responses with comments such as \\\\\\\\\\\\\\\"see attachments\\\\\\\\\\\\\\\" may be considered incomplete.

Supplemental Information

Our drive every decision that we make, determine how we interact with others, and are at the core of who we are. We value Access, Love, Belonging, Equity, and Stewardship. We understand that a work environment that respects your work/life balance is key; that's why many of our positions are eligible for flexible work schedules and teleworking opportunities. Through support, value, and trust, our employees are empowered to grow and develop into their best self.

Opportunity for All
We strive to create a working environment that includes and respects cultural, ethnic, racial, religious, sexual orientation, and gender identity diversity. Women, racial and ethnic minorities, people with disabilities, people over 40 years of age, people with religious beliefs, veterans or people with military status, and people of all sexual orientations and gender identities are encouraged to apply.

The Employment Security Department is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.

If you are a person needing assistance in the application process, if you need this job announcement in an alternate format, or if you have general questions about this opportunity, please contact 564-200-2475 the , or Washington Relay Service 711. If you are having technical difficulties creating, accessing, or completing your application, please contact careershelp@des.wa.gov or (360) 664-1960 or toll free (877) 664-1960, Washington Relay 711.

** **

Washington State

Position Details

POSTED:

Feb 02, 2024

EMPLOYMENT:

Full-time

SALARY:

76188 per year

SNAPRECRUIT ID:

S-1707363087-bfa19a6ad915aa5d6883c0f1621e8998

LOCATION:

Texas United States

CITY:

Thurston County

Job Origin:

jpick2

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Description

The ideal candidate will be knowledgeable and experienced in matters related to Paid Family Medical Leave (PFML) and processes to determine eligibility, and the adjudication process. You will be a member of the LCD Compliance Unit and report to the Administrative Hearings Supervisor. Coordinating, planning, developing, reviewing, and revising decisions and case actions regarding PFML benefits.
In this critical role you will ensure that we are meeting ESD's objectives of being good stewards of public resources by ensuring the Paid Family and Medical Leave (PFML) and Long-Term Services and Support (LTSS) trust funds have the appropriate compliance and enforcement activities surrounding them so that the programs have the necessary funding to provide benefits to Washingtonians. You will examine and research PFML-appeals made by claimants and employers, and serve as a liaison between ESD, the Attorney General Office (AGO), and the Office of Administrative Hearings (OAH) ensuring ESD decision are consistent with the AGO and OAH interpretation of Washington Administrative Code (WAC) and Revised Code of Washington (RCW). This position is a full-time/permanent Hearings Specialist and reports to the Administrative Hearings Supervisor.

Duties

A Hearings Specialist's primary responsibility is to review appeals requests, take action, and represent ESD through the adjudicative procedures. Reviewing and researching escalated claimant grievance for PFML benefits, reviewing submitted appeals for validity, and determining if proper data gathering and verification techniques were adequately documented. You are required to represent ESD at a hearing.

Some of what you will do:
  • Determine and design appeal processing schedule and guidelines on case-by-case basis.
  • Monitors, tracks, and reports on highly sensitive claimant and employers appeals as determined by caseworker.
  • Identifies and assembles documents to be used as hearings exhibits.
  • Represents the ESD through the adjudication process and take actions based on hearing outcomes.
  • Oversees the preparation of appeal summaries, correspondence and documents information for tracking/trending data.
  • Be a witness to testify at hearings.
For a full description of duties, please click here to request from recruiter:

Qualifications

Required:
A combination of experience and education equivalent to seven (7) years which includes a minimum of three (3) years of demonstrated experience in two or more of the following areas:
  • Conducting research
  • Analyzing policies, laws, rules, or regulations
  • Conducting business analysis and developing requirements
  • Leading business projects
  • Managing business operations
  • Business policy development
  • Administrating appeals
  • Adjudicating insurance claims and/or benefit applications
Preferred:
  • Experience working with appeals.
  • Knowledge of PFML rules, laws, regulations, and policies.
  • Completion of a paralegal program or experience working as a paralegal.
Additional Requirement of Employment:
  • Must be able to pass an Unemployment Insurance (UI) Claim & Benefit Information Review.
Please submit only the required documents as noted below and ensure all Personal Identifying Information (PII) such as Social Security numbers etc. are edited out of your materials for privacy.

Attach your Cover Letter, and Resume with your through the \\\\\\\\\\\\\\\"Add Attachments\\\\\\\\\\\\\\\" field. A resume will not substitute for the \\\\\\\\\\\\\\\"work experience\\\\\\\\\\\\\\\" section of the application or vice versa. Applications with blank fields, or supplemental question responses with comments such as \\\\\\\\\\\\\\\"see attachments\\\\\\\\\\\\\\\" may be considered incomplete.

Supplemental Information

Our drive every decision that we make, determine how we interact with others, and are at the core of who we are. We value Access, Love, Belonging, Equity, and Stewardship. We understand that a work environment that respects your work/life balance is key; that's why many of our positions are eligible for flexible work schedules and teleworking opportunities. Through support, value, and trust, our employees are empowered to grow and develop into their best self.

Opportunity for All
We strive to create a working environment that includes and respects cultural, ethnic, racial, religious, sexual orientation, and gender identity diversity. Women, racial and ethnic minorities, people with disabilities, people over 40 years of age, people with religious beliefs, veterans or people with military status, and people of all sexual orientations and gender identities are encouraged to apply.

The Employment Security Department is an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.

If you are a person needing assistance in the application process, if you need this job announcement in an alternate format, or if you have general questions about this opportunity, please contact 564-200-2475 the , or Washington Relay Service 711. If you are having technical difficulties creating, accessing, or completing your application, please contact careershelp@des.wa.gov or (360) 664-1960 or toll free (877) 664-1960, Washington Relay 711.

** **

Washington State

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