Workers Compensation Return to Work Claim Professional

Overview Manage Workers' Compensation claims from initiation through resolution, including negotiations, settlement, and coordination with medical and legal resources. Salary range: $67,000 - $110,600. Responsibilities Conduct investigations, assess policy coverage, and contact insureds, injured workers, medical providers, and other parties. Establish and update reserves, including actuarial reserves, and document rationale. Determine causal relatedness of medical conditions and manage files with emphasis on quality and timely resolution. Collaborate with internal nurse resources and specialty resources (medical and legal) to pursue claim resolution opportunities. Develop strategies to manage losses involving statutory benefit entitlement, Medicare Set Asides, and other statutory requirements. Prepare necessary letters and state filings within statutory limits and pursue offset opportunities (apportionment, contribution, subrogation). Evaluate claims for potential fraud and manage inventory with documented action plans for timely closing or reassignment. Effectively manage litigation to drive files to optimal outcomes, including benefits resolution and settlement negotiations. Negotiate settlement of claims within designated authority, using structured settlement/annuity as appropriate for each jurisdiction. Acquire and maintain required insurance licenses within specified timeframe. Perform other duties as assigned. Qualifications 2 years of Workers' Compensation claim handling experience. High School Diploma or GED. 1 year of Workers' Compensation claim handling experience or successful completion of the WC trainee program. Analytical Thinking – identifies problems, analyzes information, and explores solutions. Communication – expresses and records thoughts clearly orally and in writing. Negotiation – intermediate ability to influence stakeholders and reach fair agreements. General Insurance Contract Knowledge – interprets policies and determines coverage. Principles of Investigation – intermediate investigative skills and accurate event reconstruction. Value Determination – assigns dollar value to damages and sets reserves. Settlement Techniques – assesses settlement timing and content of settlement offers. Legal Knowledge – understanding of state, federal, and regulatory laws, evidence rules, and court procedures. Medical Knowledge – intermediate knowledge of injury nature, disability, and treatment. WC Technical – intermediate understanding of WC products and available resources. Customer Service – advanced ability to build and maintain productive relationships. Teamwork – advanced ability to work collaboratively with interdependent actions. Planning & Organizing – advanced ability to establish plans and contingencies. Maintain continuing education requirements as mandated by state regulations. Benefits Health insurance for employees and eligible families from day one of employment. Retirement: 401(k) match up to 5% of eligible pay and a fully funded Pension Plan. Paid Time Off: minimum 20 days annually plus nine paid company holidays. Wellness program that includes mental health counseling, health coaching, and wellness tools. Volunteer encouragement with Matching Gift and Volunteer Rewards program. EEO Statement Travelers is an equal opportunity employer. We value the unique talents each individual brings and recognize the benefits of diverse perspectives. In accordance with local law, candidates in Colorado are not required to disclose educational dates to employers. Travelers reserves the right to fill this position at a level above or below the level included in this posting. #J-18808-Ljbffr Travelers Canada