Workers’ Comp Return-to-Work Claims Specialist

Travelers Canada; United States; On-site; USD 67,000 - 111,000; Full time

Benefits offered by this job

Health Insurance

Retirement Plan

PTO (Paid Time Off)

Wellness Program

Volunteer Matches

Job summary

Travelers is seeking an experienced claims professional to manage workers' compensation claims from notice to closure. You will coordinate medical and indemnity positions with a Medical Case Manager and handle low to moderate complexity files, escalating as needed.

The role emphasizes investigations, reserving, negotiation, collaboration with medical and legal resources, and maintaining high file quality to achieve favorable outcomes for injured workers.

Qualifications

• 2 years Workers Compensation claim handling experience.
• Analytical Thinking and problem solving.
• Communication: clear written and oral communication.
• Negotiation: ability to reach fair agreements.
• General Insurance Contract Knowledge: interpret policies and contracts.
• Principles of Investigation: systematic inquiry to reconstruct events.
• Value Determination: assess liability and set reserves.
• Settlement Techniques: determine settlement approach and offers.
• Legal Knowledge: understanding of state and federal rules applicable to the insurance industry.
• Medical Knowledge: understanding injuries and treatment needs.
• WC Technical: knowledge of WC products and jurisdictional parameters.
• Customer Service: build relationships and deliver results.
• Teamwork: collaborate with others for outcomes.
• Planning & Organizing: plan actions to meet goals.
• Continuing Education requirements as required by state regulations.

Responsibilities

• Conduct investigations, assess policy coverage and determine compensability.
• Establish and update reserves to reflect claim exposure and rationale.
• Identify and set actuarial reserves.
• Apply knowledge to determine causal relatedness of medical conditions.
• Manage files with emphasis on timely contact and proper documentation.
• Aim for positive outcomes by returning injured workers to work and coordinating medical treatment.
• Collaborate with medical and legal resources to pursue claim resolution opportunities.
• Develop strategies to manage losses involving entitlement and Medicare Set Aside.

Skills

Analytical Thinking

Communication

Negotiation

Insurance Knowledge

Investigation

Value Determination

Settlement Techniques

Legal Knowledge

Medical Knowledge

WC Technical

Customer Service

Teamwork

Planning & Organizing

Education

High School Diploma or GED

Job description

Travelers is seeking an experienced claims professional to manage workers' compensation claims from notice to closure. You will coordinate medical and indemnity positions with a Medical Case Manager and handle low to moderate complexity files, escalating as needed.

The role emphasizes investigations, reserving, negotiation, collaboration with medical and legal resources, and maintaining high file quality to achieve favorable outcomes for injured workers.