Workers Compensation Claim Representative
Company: The Travelers Companies, Inc.
Posted on: June 18, 2022
Who Are We?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 160 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.Compensation OverviewThe 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$57,000.00 - $94,000.00Target Openings1What Is the
Opportunity?Potential for signing bonus of up to $5000.
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.
As part of the hiring process, this position requires the
completion of an online pre-employment assessment. Further
information regarding the assessment including an accommodation
process, if needed, will be provided at such time as your candidacy
is deemed appropriate for further consideration.
Travelers offers a hybrid work location model that is designed to
support flexibility. #HybridWhat 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
- Establish and update reserves to reflect claim exposure and
document rationale. Identify and set actuarial reserves. Apply
knowledge to determine causal relatedness of medical
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- Customer Service:
- Advanced ability to build and maintain productive relationships
with our insureds and deliver results with optimal outcomes
- Advanced ability to work together in situations when actions
are interdependent and a team is mutually responsible to produce a
- Planning & Organizing:
- Advanced ability to establish a plan/course of action and
contingencies for self or others to meet current or future
- Maintain Continuing Education requirements as required or as
mandated by state regulationsWhat is a Must Have?
- High School Diploma or GED required.
- Minimum of 1 year Workers Compensation claim handling
experience or successful completion of the WC trainee program
required.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
- Wellness Program: The Travelers wellness program is comprised
of tools and resources that empower you to achieve your wellness
goals. In addition, our Life Balance program provides access to
professional counseling services, life coaching and other resources
to support your daily life needs. Through Life Balance, you're
eligible for five free counseling sessions with a licensed
- 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.
- Bilingual candidates encouraged to apply.Employment
PracticesTravelers 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
If you are a candidate and have specific questions regarding the
physical requirements of this role, please send us 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.To learn more about our
comprehensive benefit programs please visit
Keywords: The Travelers Companies, Inc., Naperville , Workers Compensation Claim Representative, Other , Naperville, Illinois
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