Workers' Compensation Claims Specialist

Travelers; Chicago, Downers Grove (IL, IL); On-site; USD 67,000 - 111,000; Full time

Benefits offered by this job

Health Insurance

401(k) Matching

Paid Time Off

Wellness Program

Volunteer Rewards

Job summary

Travelers in the United States is seeking a Workers' Compensation Claims professional to manage claims with lost time to conclusion and negotiate settlements. You will coordinate medical and indemnity positions with a Medical Case Manager and independently handle low to moderate complexity claims with potential for more complex work under supervision.

Role requires analyzing medical factors, setting reserves, and collaborating with nurses and legal teams to reach optimal outcomes, including

Qualifications

• 2 years Workers' Compensation claim handling experience.
• Ability to interpret insurance contracts and policy language.
• Strong analytical thinking and problem-solving skills.
• Excellent written and verbal communication and negotiation skills.
• Knowledge of Medicare Set Aside concepts and allocations.
• Ability to manage file quality, reserves, and settlements.

Responsibilities

• Conduct investigations to determine compensability and coverage.
• Establish and update reserves reflecting claim exposure.
• Identify and set actuarial reserves and monitor progress.
• Assess causal relationships of medical conditions and determine payouts.
• Manage files with timely contact and documentation.
• Facilitate return-to-work plans with medical and nurse resources.
• Collaborate with medical/legal experts to pursue settlement opportunities.
• Develop strategies for losses, offsets, and subrogation opportunities.
• Evaluate claims for potential fraud and litigation risk.
• Prepare required letters and state filings within deadlines.
• Negotiate settlements within authority and consider structured settlements when appropriate.
• Maintain licensure requirements and continuing education as needed.

Skills

Analytical Thinking

Communication

Negotiation

General Insurance Knowledge

Principles of Investigation

Value Determination

Settlement Techniques

Legal Knowledge

Medical Knowledge

WC Technical

Customer Service

Teamwork

Planning & Organizing

Continuing Education

Education

High School Diploma or GED

Job description

Travelers in the United States is seeking a Workers' Compensation Claims professional to manage claims with lost time to conclusion and negotiate settlements. You will coordinate medical and indemnity positions with a Medical Case Manager and independently handle low to moderate complexity claims with potential for more complex work under supervision.

Role requires analyzing medical factors, setting reserves, and collaborating with nurses and legal teams to reach optimal outcomes, including