The Travelers Companies, Inc

Workers Compensation Claim Representative

The Travelers Companies, Inc • $67K — $110K *
Walnut Creek, CA 94598In-Person
Finance & Insurance
Less than 5 years of experience
Today
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Job Overview by Ladders

Qualifications

  • 2 years of Workers' Compensation claim handling experience.
  • Strong analytical skills for problem identification and solutions analysis.
  • Effective communication skills, both written and oral.
  • Negotiation skills to reach fair agreements.
  • Intermediate knowledge of legal and regulatory aspects of insurance.

Responsibilities

  • Conduct thorough investigations to determine compensability.
  • Establish and update financial reserves based on claim exposure.
  • Manage case files with a focus on quality and proactive issue resolution.
  • Collaborate with specialists to promote claim resolution strategies.
  • Negotiate settlements within authority limits.

Benefits

  • Comprehensive health insurance for employees and eligible family members starting on day one.
  • 401(k) plan with dollar-for-dollar match on contributions up to 5% and additional student loan support.
  • Minimum of 20 days Paid Time Off and nine paid company holidays annually.
  • Access to a wellness program with resources for mental health and lifestyle management.
  • Encouragement and programs for community service involvement.
Full Job Description
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. As part of our comprehensive compensation and benefits program, 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 with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery The injured worker is working modified duty and receiving ongoing medical treatment. The injured worker as returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. With close to moderate supervision, may handle claims of greater complexity where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and there has been a change in the current position. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered.What Will You Do?
  • Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner 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 an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). Achieve a positive end result by returning injured party to work and coordinating the appropriate medical treatment.in collaboration with internal nurse resources where appropriate.
  • Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome.
  • Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy.Prepare necessary letters and state filings within statutory limits.
  • Pursue all offset opportunities, including apportionment, contribution and subrogation. Evaluate claims for potential fraud.Proactively manage inventory with documented plans of action to ensure timely and appropriate file 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 settlement of claims within designated authority. May use structured settlement/annuity as appropriate for the jurisdiction.
  • In order to perform the essential functions of this job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) must be obtained within three months of starting the job and obtain ongoing continuing education credits as mandated.
  • Perform other duties as assigned.
What Will Our Ideal Candidate Have?
  • 2 years Workers Compensation claim handling experience.
  • Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making.
  • Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology.
  • Ability to effectively present file resolution to internal and/or external stakeholders.
  • Negotiation: Intermediate ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise.
  • General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract.
  • Principles of Investigation: Intermediate investigative skills including the ability to take statements.
  • Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss.
  • Value Determination: Intermediate ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves.
  • Settlement Techniques: Intermediate ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package.
  • Legal Knowledge: General knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
  • Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed.
  • WC Technical:
  • Intermediate ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims.
  • Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state.
  • Intermediate knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry.
  • Customer Service:
  • Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes.
  • Teamwork:
  • Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result.
  • Planning & Organizing:
  • Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals.
  • Maintain Continuing Education requirements as required or as mandated by 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.


What Is in It for You?
  • Health Insurance: Employees and their eligible family members - including spouses, domestic partners, and children - are eligible for coverage from the first day of employment.
  • Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
  • Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
  • Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
  • Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.

About The Travelers Companies, Inc

Travelers is an insurance leader, committed to keeping pace with the ever-changing needs of their customers and anticipating their needs for the future. There is no stronger testament to their dedication to protecting customers from loss than their continued innovation and ability to transform their industry. In fact, from the first-ever auto and space travel policies and hybrid car discount, to the 2009 founding of The Travelers Institute for public policy, their history of advancements has propelled their company—and their industry—towards ever higher standards for customers. Travelers is a company that works hard at the science of what they do: they analyze information, process perspectives and measure results to create the best combination of products and services. They work equally hard at customer service and how they interact with the people whom they do business. Over the years, they've strived to earn their customer's loyalty by continually improving their abilities to listen and respond to their needs.

The Travelers Companies, Inc Careers

Join the vibrant team at The Travelers Companies, Inc, a leader in the insurance industry, and propel your career to new heights with a company known for its commitment to innovation, leadership, and professional growth.

Explore Job Opportunities and Growth

At The Travelers Companies, Inc, we offer a plethora of job opportunities that cater to a variety of skills and professional interests. Whether you're seeking a position in management, customer service, underwriting, or IT, we have a place for you. Our commitment to professional growth means we provide unparalleled career advancement tools and leadership training to help you climb the ladder of success.

Internship Programs: A Gateway to Employment

Kickstart your career with our dynamic internship programs. These opportunities are designed not just to teach, but to challenge and expand your understanding of the industry. Internships at Travelers are a perfect way to enhance your resume and gain valuable real-world experience, making you a competitive candidate for future employment.

Culture and Benefits

At The Travelers Companies, Inc, we pride ourselves on a culture that fosters diversity, networking, and innovation. Our team is our family, and we support each other's professional and personal growth. The benefits at Travelers are comprehensive, designed to meet the diverse needs of our employees, including health, wellness, and continuous education.

Hiring Process: What to Expect

Our hiring process is straightforward and transparent, designed to find passionate, curious, and solution-driven team players. From the initial application and resume submission to the interview, we ensure that every candidate is treated with respect and given a fair chance to demonstrate their capabilities.

Career Development and Training

We believe in nurturing talent and providing our team with the tools they need to succeed. Our career development programs include professional training, diversity training, and skills enhancement workshops. These resources are tailored to foster innovation and empower our employees with the latest industry knowledge and best practices.

Join Our Team

Are you ready to explore the exciting career opportunities at The Travelers Companies, Inc? Search open positions that match your skills and interests. We are always looking for individuals who are driven to innovate and lead.

Stay Connected

Keep up to date with the latest news, insider perspectives, and industry-leading insights you can put to use today—all from the people who work here. Personalize your subscription to receive job alerts, latest news, and insider tips tailored to your preferences. Discover the rewarding opportunities that await at The Travelers Companies, Inc.

Explore Careers at The Travelers Companies, Inc

Embark on a journey of growth, opportunity, and excellence. At The Travelers Companies, Inc, your career is just beginning. Join us and make a difference in a company that values leadership, diversity, and forward-thinking.
Learn more about The Travelers Companies, Inc
Size
30,800 employees
Market Cap
$44.1 billion
Industry
Finance & Insurance
Net Income
$2.6 billion
Founded
1853
5 Year Trend
+4.7%
Revenue
$32 billion
NASDAQ
TRV
* Ladders Estimates

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