Claims Representative - Workers' Compensation

Workers' Compensation Claims Representative

Western National Insurance Group is a private mutual insurance company with over 120 years of experience serving customers' property-and-casualty insurance needs in the Midwestern, Northwestern, and Southwestern United States. Known as "The Relationship Company®," we define success as a measure of the relationships we've built over time. In everything that we do, we know that delivering a friendly and helpful interaction makes for a better experience for everyone involved. That's the power of "nice". At Western National, nice is something we work to bring to every person and organization with whom we partner and serve.

Western National is seeking a Workers' Compensation Claims Representative to join our team!

The individual in this role will have the opportunity to investigate, evaluate, negotiate, and resolve Workers' Compensation insurance claims as assigned.

Responsibilities and opportunities of this role include:

• Investigates, evaluates, negotiates, and resolves Workers' Compensation claims as assigned.
• Handles moderate-to-high complexity claims within settlement authority.
• Ensures customer service excellence.
• Investigates and reviews policy forms, facts, and documents related to claims to make appropriate decisions on claims resolution.
• Assesses claim exposures and develops strategic action plans to drive efficient, fair, and cost-effective resolutions.
• Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience, maintaining appropriate reports to ensure current status of claims are clearly documented at all times.
• Provides direction to outside resources.
• Makes decisions guided by general instructions and practices requiring interpretation.
• Coordinates and collaborates with cross-functional specialists – loss prevention, legal counsel, unit managers, special investigations unit, HR partners, safety directors, and fellow examiners – to support accurate determination of injury mechanisms and case strategy.
• Makes recommendations to solve more complex problems.
• Recognizes problems or situations that are new or lack clear precedent.
• Finds solutions using a systematic, multi-step approach.
• Develops improvements and innovations to enhance performance.
• Collaborates with all stakeholders involved in the claim lifecycle, including policyholders, agents, claimants, and internal partners.
• Handles regular contact with outside vendors.
• Travels on short notice for field work as required (e.g., scene investigations, inspecting property losses).
• Performs special projects and other duties as assigned.

Must-have qualifications for a candidate include:

• A minimum of two years of experience with Workers' Compensation claims.
• Strong understanding of industry practices, standards, and claims concepts.
• Ability to multitask and solve problems.
• Ability to identify and investigate potential fraud indicators, including irregularities in medical treatment, billing practices, and reported injury details.
• Proficient oral and written communication skills.
• Strong negotiation and relationship-building skills.
• Analytical with the ability to exercise sound business judgment.
• Strong time management skills.
• Bachelor's degree or related experience.

Ideal candidates will have:

• Prior experience managing Workers' Compensation claims in several of our operating states is preferred (e.g., Alaska, Illinois, Iowa, Michigan, Minnesota, New York, South Dakota, or Wisconsin).
• Experience handling claims across multiple jurisdictions and navigating differing state regulations is strongly preferred.
• AIC or AINS certification strongly preferred.
• Ability to manage the end-to-end claims process in alignment with client expectations, corporate policies, industry best practices, and all statutory, regulatory, and ethical requirements.
• Proficient use of various core systems, office and computer equipment, and software packages.

Compensation overview:

The full hiring range for this role is $59,200 - $94,000, annually. However, the base pay offered may vary depending on the job-related knowledge, skills, credentials, and experience of each candidate, as well as other factors such as the scope and location of the role. Candidates looking for compensation outside of the posted range are encouraged to apply and will be considered based on their individual qualifications and / or may be considered for other positions.

Western National Insurance Group reserves the right to fill this position at a level above or below the level included in this posting.

Culture and total rewards:

Western National has long been known as "The Relationship Company®" and caring for our employees is part of that relationship commitment. We value connectiveness, empowerment, and accountability, and we believe that our employees are our biggest asset.

Currently ranked as the 41st largest private company by revenue in Minnesota (Minneapolis/St. Paul Business Journal), Western National has earned accolades year-over-year as an employer of choice and garnered multiple awards for wellness in the workplace. Western National has also been named a Top Workplace by the Star Tribune for the past four consecutive years. In addition, the Group is consistently recognized as a Ward's 50 property-and-casualty insurance company for its outstanding financial results.

Western National offers full-time employees a significant Total Rewards Package, including:

• Medical insurance plan options and other standard employee benefits, including dental insurance, vision benefits, life insurance, disability insurance, and more!
• Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA)
• 401(k) Plan (participants are eligible for 100% matching on the first 6% of their contributions)
• Wellbeing Program, including onsite fitness studio
• Paid Time Off – including holiday, vacation, and volunteer
• 100% company-paid tuition reimbursement for approved job-relevant coursework and access to The Institutes (Risk and insurance education)
• Paid parental leave
• Bonus opportunities

Western National believes in supporting balance between work and life by providing a flexible work environment, which includes a variety of hybrid and remote work arrangements designed to balance individual, job, department, and company needs.

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Western National provides employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.