Workers Compensation Claim Representative - Richmond VA

Job Description ATTENTION MILITARY AFFILIATED JOB SEEKERS – Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Job Category Claim Compensation Overview The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including 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 Target Openings 1 What Is the Opportunity? Manage Workers' Compensation claims from initial loss assessment through to conclusion, negotiating settlements where appropriate. Coordinate the medical and indemnity position of the claim with a Medical Case Manager. Handle assigned claims of low to moderate complexity where wage loss is expected to result in return to work or Modified Duty, or attainment of Maximum Medical Improvement (MMI) with no Return to Work. Oversee claims involving minor to moderate litigation, as well as more complex cases where the injured worker may remain out of work, face permanent restrictions, or be involved in litigation over permanency ratings or causality. Manage high‑impact cases that may involve multiple surgeries, major office or orthopedic procedures, and potential settlement opportunities. Work in a hybrid model that supports flexibility and collaboration with internal nurse resources and specialty resources such as medical and legal teams. What Will You Do? Conduct investigations to determine policy coverage, including contacting insureds, injured workers, medical providers, and other parties. Establish and update reserves to reflect claim exposure and document rationale. Apply actuarial reserve knowledge to determine causal relatedness of medical conditions. Manage files with an emphasis on quality, ensuring timely contact, proper documentation, and proactive resolution of outstanding issues. 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. Develop strategies to manage losses involving statutory benefit entitlement, medical diagnoses, Medicare Set Asides, and allocation of benefits. Prepare necessary letters and state filings within statutory limits. Pursue offset opportunities, including apportionment, contribution, and subrogation, while evaluating claims for potential fraud. Effectively manage litigation to drive files to optimal outcomes, including resolution of benefits and application of Medicare Set Asides and allocations. Negotiate settlement of claims within designated authority, including structured settlement or annuity options when appropriate. Maintain required Insurance License(s) within three months of starting the job and obtain ongoing continuing education credits as mandated. Perform other duties as assigned. Minimum Education Required High School/GED Additional Qualifications / Responsibilities What Will Our Ideal Candidate Have? 2 Years Workers Compensation Claim Handling Experience. Analytical Thinking – Ability to identify problems, synthesize information, and explore alternative solutions. Communication – Clear written and oral communication skills. Presentation – Ability to present file resolution to stakeholders. Negotiation – Intermediate ability to influence stakeholders and reach fair agreements through discussion and compromise. General Insurance Contract Knowledge – Interpret policies and contracts and determine scope of loss. Principles of Investigation – Intermediate investigative skills and ability to take statements. Value Determination – Intermediate ability to assess liability, assign dollar values, and adjust reserves. Settlement Techniques – Intermediate assessment of settlement timing and offer content. Legal Knowledge – General understanding of state, federal and regulatory laws, rules of evidence, discovery, and court procedures relevant to insurance. Medical Knowledge – Intermediate knowledge of injuries, disability periods, and treatment needs. WC Technical – Demonstrated understanding of WC products, available resources and technology to resolve claims. Customer Service – Advanced ability to build and maintain productive relationships with insureds. Teamwork – Advanced ability to work collaboratively toward shared results. Planning & Organizing – Advanced ability to establish plans and contingencies. State licensing and continuing education – Ability to maintain required state regulations. What is a Must Have? High School Diploma or GED. 1 year Workers Compensation claim handling experience or successful completion of the WC trainee program. Location City: Richmond State: Virginia Job Code Ins Insurance Affiliate Sponsor Travelers Insurance #J-18808-Ljbffr