Experienced Workers Compensation Claim Representative

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

$71,900.00 - $118,700.00

1

Applicants who are licensed to handle Workers Compensation Claims in Montana are strongly preferred.

The selected candidate must reside in or be willing to relocate at their own expense to Montana State.

Travelers' Claim Organization is at the heart of our business. By providing assurance to our customers during life's rainy days, the Travelers Workers Compensation Claim team is committed to partnering with our business insurance customers to help their injured employees return to work as soon as medically appropriate. As a Specialized Senior Claim Rep, you will be responsible for investigating, evaluating, reserving, negotiating, and resolving Workers Compensation claims from Travelers Single Adjuster Model including Constitution State Services (CSS) and Custom Comp claims, which will be the majority of the claims handled, and other Travelers Workers Compensation claims. In this role you may be responsible for interpreting and applying laws and statutes for multiple state jurisdictions as well as unique customer (Special Account Communication/SAC) and fronting carrier handling expectations. You will provide quality claim handling throughout the entire claim life cycle including litigation management and maintaining full compliance with internal and external quality standards and state specific regulations. In addition, you may be a consultant, training resource, and technical resource to the field and our business partners.

What Will You Do?

• Complete investigations and make decisions and recommendations for claims with varying levels of severity and complexity across multiple jurisdictions.
• Establish and update estimates to reflect exposure.
• Develop and employ creative resolution strategies. Implement proactive action plans and resolution strategies created in partnership with customers, fronting carriers, and stakeholders.
• Communicate claim status efficiently and effectively with all parties, which may include business partners, injured employees, medical providers, and legal counsel while utilizing various digital channels, actively listening, and processing information. Maintain open lines of communication and anticipates touchpoints to engage the customer so they are kept apprised of any changes on each claim and to discuss strategies.
• Provide quality customer service, ensure file quality, timely coverage analysis, and communication with the customer based on application of policy information to facts or allegations of each case. Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions, as well as adhering to fronting carrier handling requirements.
• Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively resolve claims.
• Maintain and document claim file activities in accordance with established procedures and customer/fronting carrier expectations.
• To perform the essential functions of the job, acquisition and maintenance of Insurance License(s) may be required to comply with state and Travelers requirements. Generally, license(s) much 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?

• Bachelor’s Degree.
• Three Years of Workers Compensation claim handling.
• Experience with compensability investigations, proactive return to work strategy, medical management, complex injury management, initiative-taking resolution tactics, litigation management and extensive jurisdictional knowledge.
• Strong evaluation, critical and analytical skills, with the ability to review information from multiple sources to accurately achieve optimal claim outcomes and determine appropriate next steps.
• Understanding of Fronting Carrier relationship and reporting requirements.
• Able to make independent decisions while working in a high volume, fast paced environment managing multiple priorities while facing ambiguity.
• Develop and build strong working relationships with both internal and external business partners.
• Provide excellent customer experience by communicating effectively, verbally and written.
• Demonstrate coaching, influence, and persuasion skills.
• Able in a team environment while adapting and championing change in an agile environment.

What is a Must Have?

• High School Diploma/ GED or equivalent.
• Two years Workers Compensation claim handling experience.