Workers Compensation Claim Representative

About Us Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it. Opportunity Manage Workers’ Compensation claims from 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 handle assigned claims of low to moderate complexity, where wage loss and the expectation is a return to work to modified or full duty or obtaining maximum medical improvement (MMI) with no return to work (RTW). Claims may involve minor sprains, minor to moderate surgery, or more complex litigation issues. Injured workers may be working modified duty, receiving ongoing medical treatment, or have returned to work with permanent restrictions and/or vocational rehabilitation. Claims that have been reopened for additional medical treatment on more complex files and involve multiple surgeries or permanent fatalities may also be considered for settlement. Compensation & Benefits The annual base salary range for this position is a nationwide market range. The actual salary will be determined by the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. Employees are also eligible for performance‑based cash incentive awards. Salary Range: $67,000.00 – $110,600.00. Health Insurance: Employees and eligible family members – including spouses, domestic partners, and children – are covered from the first day of employment. Retirement: Travel's matches your 401(…) contributions dollar-for-dollar up to your first 5% of eligible pay. A Pension Plan that is 100% funded by Travelers is also available. Paid Time Off: Minimum of 20 days PTO annually, plus nine paid company holidays. Wellness Program: Tools, discounts and resources to achieve wellness goals; mental health program with free counseling, health coaching and other resources. Volunteer Encouragement: A Matching Gift and Volunteer Rewards program enables you to give back to the charity of your choice. Responsibilities 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, including actuarial reserves. Manage files with an emphasis on file quality, ensuring timely contact, proper documentation and proactive resolution of outstanding issues. Aim for a positive end result by returning injured parties to work and coordinating appropriate medical treatment in collaboration with internal nurse resources. Collaborate with specialty resources (medical and legal) to pursue claim resolution opportunities such as return to work, structured settlements, and discontinuation of benefits through litigation. Integrate delivery of medical services into the overall claim strategy, preparing necessary letters and state filings within statutory limits. Pursue all offset opportunities, including apportionment, contribution and subrogation, and evaluate claims for potential fraud. Effectively manage litigation to drive files to an optimal outcome, including resolution of benefits and application of Medicare Set‑Aside allocations. Negotiate settlement of claims within designated authority, possibly using structured settlements or annuity as appropriate. Maintain required Insurance License(s) and ongoing continuing education credits as mandated by state and Travelers requirements. Perform other duties as assigned. Qualifications 2 years of Workers Compensation claim handling experience. Analytical thinking: Identify problems, analyze and synthesize information, and explore alternative solutions. Communication: Express, summarize and record thoughts clearly and concisely, both orally and in writing. Ability to present file resolution to stakeholders. Negotiation: Intermediate ability to influence stakeholders and reach fair agreements. General Insurance Contract Knowledge: Interpret policies, apply loss facts, and determine coverage. Principles of Investigation: Intermediate investigative skills, including taking statements. Value Determination: Intermediate ability to estimate liability and adjust reserves. Settlement Techniques: Intermediate ability to manage claim settlements and offer composition. Legal Knowledge: Understanding of state, federal and regulatory laws, evidence rules, and court procedures relevant to insurance. Medical Knowledge: Intermediate understanding of injury nature, disability periods and treatment. WC Technical: Intermediate ability to apply WC products and technology to resolve claims. Ability to work within jurisdictional parameters of assigned state. Customer Service: Advanced ability to build and maintain productive relationships with insureds. Teamwork: Advanced ability to collaborate when actions are interdependent. Planning & Organizing: Advanced ability to establish plans and contingencies for self or others. Maintain Continuing Education requirements as mandated by state regulations. Must Have High School Diploma or GED. 1 year of Workers Compensation claim handling experience or successful completion of the WC trainee program. Employment Practices Travelers is an equal opportunity employer. We value the unique abilities and talents each individual brings to our organization and recognize that we benefit in numerous ways from our differences. In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions. For specific questions regarding the physical requirements of this role, please send an email so we may assist you. Travelers reserves the right to fill this position at a level above or below the level included in this posting. #J-18808-Ljbffr