Workers Compensation (L&I) Coordinator | Permanent WFH

We are seeking an experienced Workers Compensation (L&I) Coordinator to manage the full lifecycle of Washington State Labor & Industries (L&I) workers compensation surgical cases, from patient identification through return-to-work (RTW) resolution.

This role is ideal for professionals with hands-on experience managing Washington L&I claims within insurance companies, third-party administrators (TPAs), self-insured employers, case management firms, healthcare organizations, or similar environments.

The Coordinator will serve as the primary liaison among injured workers, physicians, employers, vocational counselors, nurse case managers, and claims managers, while ensuring accurate and timely documentation, compliance, billing, and case coordination. The role also includes medical records supervisory responsibilities, including staff training, scheduling, performance monitoring, and coaching.

Key Responsibilities

Case Coordination & Workflow

• Identify surgical patients and maintain an accurate case list for ongoing tracking and follow-up.
• Coordinate workers compensation cases from surgical planning through return-to-work resolution.
• Coordinate vocational rehabilitation activities, Functional Capacity Evaluations (FCEs), and outgoing referrals.
• Monitor physical therapy progress and follow up on treatment-related concerns, medication issues, or complications.
• Communicate changes, delays, or barriers affecting patient care and RTW status to physicians and relevant stakeholders.
• Maintain accurate case tracking using established SHSC workflows and tracking tools.
  
  

Stakeholder Communication

• Serve as the primary contact for injured workers regarding return-to-work questions, case status, and documentation.
• Coordinate interpreter services for non-English-speaking injured workers when needed.
• Communicate with employers, vocational counselors, nurse case managers, claims managers, and other stakeholders to resolve case issues.
• Identify and escalate barriers that may delay treatment, recovery, or return to work.
• Handle incoming calls related to scheduling, documentation, and case status.
• Coordinate attorney, vocational, and other case-related meetings as needed.
  
  

L&I Documentation & Compliance

• Maintain complete and accurate documentation of case activity and communications in L&I MAVIN/OHMS or applicable systems.
• Ensure documentation meets SHSC Handbook and SQCP standards, while maintaining strict confidentiality.
• Process Activity Prescription Forms (APFs), Time Loss documentation, and other disability paperwork.
• Create and manage EHR tasks related to incoming forms and documentation.
• Review clinical documentation, prepare forms for provider signatures, and submit completed documents through the appropriate channels.
• Process electronic APFs and Time Loss documentation, including diagnosis code verification and PDF preparation.
• Complete L&I and insurance forms using accurate billing and diagnosis codes.
• Ensure required forms and documentation are submitted within established 3–5 business day turnaround requirements.
  
  

Billing, Auditing & Reporting

• Manage the weekly incentive billing process for new Washington L&I patients, including self-insured claims.
• Identify visits that meet applicable 1086M billing criteria and maintain accurate tracking records.
• Prepare daily reports covering L&I appointments, chart notes, outstanding APFs, and missing documentation.
• Monitor and follow up on outstanding dictation and documentation.
• Conduct chart audits and review Utilization Review (UR) feedback from L&I audits.
• Coordinate physician responses to audit findings and ensure finalized documentation is submitted to the SQCP Program by required deadlines.
• Review billing denials, investigate issues, make necessary corrections, and coordinate claim resubmission.
  
  

Administrative & Supervisory Responsibilities

• Maintain and distribute monthly on-call schedules and update applicable calendars and after-hours contact lists.
• Train new staff on charting, L&I paperwork, documentation standards, and system workflows.
• Monitor employee timecards and coordinate staffing coverage.
• Review and manage time-off requests based on operational needs.
• Coach staff on productivity, documentation quality, compliance, and workflow expectations.
• Support continuous improvement of medical records and workers compensation processes.
  
  

Qualifications

• Hands-on experience managing Washington State workers compensation claims, including Washington L&I/State Fund and/or self-insured claims.
• Active or eligible credentialing through Washington State L&I's Structured Quality Care Program (SQCP), with willingness to obtain and maintain required credentialing.
• Strong working knowledge of Washington L&I workers compensation processes, including claims management, Time Loss, RTW coordination, and Activity Prescription Forms (APFs).
• Experience using L&I MAVIN/OHMS or a comparable workers compensation claims or case management system.
• Experience working with EHR/EMR systems for documentation, task management, chart review, and records tracking.
• Knowledge of medical billing, coding, claims processing, and denial resolution.
• Familiarity with utilization review and medical records compliance.
• Strong written and verbal communication skills.
• Excellent organizational skills and attention to detail, with the ability to manage multiple cases and strict deadlines.
• Proficiency in Microsoft Excel for case tracking, reporting, audits, and documentation.
• Experience in a medical records, revenue cycle, or workers compensation supervisory role.
• Previous experience training, coaching, or supervising administrative or clinical support staff.
• Background in workers compensation case management.
• Experience coordinating vocational rehabilitation or return-to-work programs.
• Experience with utilization review, chart audits, or quality assurance programs.
• Experience working directly with healthcare providers, employers, claims managers, and vocational professionals.
  
  

Perks

• Permanent Work From Home
• Leave Credits
• Monetary Allowance
• Annual Bonus
• Weekly Paychecks
• Fixed Weekends Off
• Thriving Company Culture with Complete Autonomy
• Exclusive Specialized Training Programs
• Unlock Your Potential with a Highly Competitive Salary
  
  

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