Travelers
Senior Workers Compensation Claim Representative
Travelers, Richmond, Virginia, United States, 23214
Overview
Senior Workers Compensation Claim Representative at Travelers. Responsibilities include managing Workers' Compensation claims with lost time to conclusion and negotiating settlements where appropriate. What Is the Opportunity?
Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity positions of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity, with considerations for wage loss, return-to-work status, and medical treatment. Some claims may involve more complex issues and litigation as appropriate to the role. What Will You Do?
Conduct investigations, including assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties to determine compensability. Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. Manage files with emphasis on file quality, timely contact, proper documentation, and proactive resolution of outstanding issues. Achieve a positive end result by returning the injured party to work and coordinating appropriate medical treatment in collaboration with internal nurse resources where appropriate. Collaborate with specialty resources (medical and legal) to pursue claim resolution opportunities (return to work, structured settlement, discontinuation of benefits through litigation). Develop strategies to manage losses involving statutory entitlement, medical diagnoses, and Medicare Set Aside to achieve the best possible outcome. Collaborate with internal nurse resources (Medical Case Manager) to integrate medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits. Pursue offset opportunities (apportionment, contribution, subrogation). Evaluate claims for potential fraud. Proactively manage inventory to ensure timely closing or reassignment. Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations. Negotiate settlements within designated authority. May use structured settlements/annuities as appropriate for the jurisdiction. Acquire and maintain Insurance License(s) as required by state Travelers requirements and complete continuing education credits. Perform other duties as assigned. What Will Our Ideal Candidate Have?
2 years Workers' Compensation claim handling experience preferred. Analytical thinking, communication, negotiation, and general insurance contract knowledge. Principles of Investigation, Value Determination, Settlement Techniques, Legal Knowledge, and Medical knowledge at an intermediate to advanced level. WC Technical: understanding of WC products and jurisdictional parameters. Customer Service: ability to build and maintain productive relationships; Teamwork; Planning & Organizing; ability to meet goals. Maintain Continuing Education requirements as required by state regulations. What Is a Must Have?
High School Diploma or GED required. Minimum of 1 year Workers' Compensation claim handling experience or successful completion of the WC trainee program required. What Is in It for You?
Health Insurance coverage from the first day of employment for employees and eligible family members. Retirement: Travelers matches 401(k) contributions up to 5% of eligible pay, with additional programs; Pension Plan fully funded by Travelers. Paid Time Off: at least 20 days annually plus nine paid holidays. Wellness Program: tools, discounts, and resources for wellness and caregiving needs, including mental health resources. Volunteer Encouragement: Matching Gift and Volunteer Rewards program. Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize our differences as a strength. Some locations have local requirements regarding education dates. For questions about physical requirements, please email us. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our benefits, visit the Travelers careers benefits page.
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Senior Workers Compensation Claim Representative at Travelers. Responsibilities include managing Workers' Compensation claims with lost time to conclusion and negotiating settlements where appropriate. What Is the Opportunity?
Manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity positions of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity, with considerations for wage loss, return-to-work status, and medical treatment. Some claims may involve more complex issues and litigation as appropriate to the role. What Will You Do?
Conduct investigations, including assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties to determine compensability. Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. Manage files with emphasis on file quality, timely contact, proper documentation, and proactive resolution of outstanding issues. Achieve a positive end result by returning the injured party to work and coordinating appropriate medical treatment in collaboration with internal nurse resources where appropriate. Collaborate with specialty resources (medical and legal) to pursue claim resolution opportunities (return to work, structured settlement, discontinuation of benefits through litigation). Develop strategies to manage losses involving statutory entitlement, medical diagnoses, and Medicare Set Aside to achieve the best possible outcome. Collaborate with internal nurse resources (Medical Case Manager) to integrate medical services into the overall claim strategy. Prepare necessary letters and state filings within statutory limits. Pursue offset opportunities (apportionment, contribution, subrogation). Evaluate claims for potential fraud. Proactively manage inventory to ensure timely closing or reassignment. Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits. Understand and apply Medicare Set Asides and allocations. Negotiate settlements within designated authority. May use structured settlements/annuities as appropriate for the jurisdiction. Acquire and maintain Insurance License(s) as required by state Travelers requirements and complete continuing education credits. Perform other duties as assigned. What Will Our Ideal Candidate Have?
2 years Workers' Compensation claim handling experience preferred. Analytical thinking, communication, negotiation, and general insurance contract knowledge. Principles of Investigation, Value Determination, Settlement Techniques, Legal Knowledge, and Medical knowledge at an intermediate to advanced level. WC Technical: understanding of WC products and jurisdictional parameters. Customer Service: ability to build and maintain productive relationships; Teamwork; Planning & Organizing; ability to meet goals. Maintain Continuing Education requirements as required by state regulations. What Is a Must Have?
High School Diploma or GED required. Minimum of 1 year Workers' Compensation claim handling experience or successful completion of the WC trainee program required. What Is in It for You?
Health Insurance coverage from the first day of employment for employees and eligible family members. Retirement: Travelers matches 401(k) contributions up to 5% of eligible pay, with additional programs; Pension Plan fully funded by Travelers. Paid Time Off: at least 20 days annually plus nine paid holidays. Wellness Program: tools, discounts, and resources for wellness and caregiving needs, including mental health resources. Volunteer Encouragement: Matching Gift and Volunteer Rewards program. Employment Practices
Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize our differences as a strength. Some locations have local requirements regarding education dates. For questions about physical requirements, please email us. Travelers reserves the right to fill this position at a level above or below the level included in this posting. To learn more about our benefits, visit the Travelers careers benefits page.
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