Workers Compensation Claim Representative Trainee
Company: The Travelers Companies, Inc.
Location: Orlando
Posted on: May 15, 2022
Job Description:
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.
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
$43,600.00 - $71,900.00
Target Openings
15
What Is the Opportunity?
This is an entry level position that requires satisfactory
completion of required training to advance to a Workers'
Compensation claim professional position. This position is intended
to develop skills for investigating, evaluating, negotiating and
resolving claims on losses of lesser value and complexity. Provides
quality claim handling throughout the claim life cycle (customer
contacts, coverage, investigation, evaluation, reserving,
negotiation and resolution) including maintaining full compliance
with internal and external quality standards and state specific
regulations. 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.
Primary Job Duties & Responsibilities
- Completes required training program which includes the overall
instruction, exposure, and preparation for employees to progress to
the next level position. It is a mix of online, virtual, classroom,
and on-the-job training. The training may require travel.
- The on the job training includes practice and execution and
coaching on the following core assignments:
- Conduct investigations, including, but not limited to assessing
policy coverage, investigation of non-questionable/questionable
claims, contacting insureds, injured workers, medical providers,
and other parties in a timely manner to determine
compensability.
- Proactively manage inventory with documented plans of action
and emphasis on file quality and data integrity to ensure timely
and appropriate resolution or reassignment.
- 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.
Manage, resolve or reassign those claims where pre-injury return to
work is unlikely.
- Establish and update reserves to reflect claim exposure and
document rationale. Identify exposures and establish appropriate
reserves. Apply knowledge to determine causal relatedness of
medical conditions.
- Collaborate with internal nurse resources (Medical Case
Manager) in order to integrate the delivery of medical services
into the overall claim strategy.
- Complete required letters and state forms and any other
required documents as required. Prepare necessary letters and state
filings within statutory limits.
- Determine and actively develop ongoing strategic plans for
resolution as required. Develop strategies to manage losses
involving issues of statutory benefit entitlement, medical
diagnoses, Medicare Set Aside to achieve resolution through the
best possible outcome. Work in collaboration with specialty
resources (i.e. medical and legal) to proactively pursue claim
resolution opportunities.
- Pursue all offset opportunities, including apportionment,
contribution and subrogation. Evaluate claims for potential
fraud.
- 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.
Evaluate and document a detailed settlement analysis, value and
range. Refer claims beyond authority as appropriate based on
exposure and established guidelines. May use structured
settlement/annuity as appropriate for the jurisdiction.
- Participate in Telephonic and/or onsite File Reviews.
- Respond to inquiries - verbal and written.
- Keeping injured worker apprised of claim status.
- Communicate and complete denials on medical and indemnity
issues.
- 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.
- In order to progress to Claim Representative, a Trainee must
demonstrate proficiency in the skills outlined above. Proficiency
will be verified by appropriate management, according to
established standards.Minimum Qualifications
- High School Diploma or GED and one year of customer service
experience OR Bachelor's Degree required.
Education, Work Experience, & Knowledge
- Bachelor's Degree preferred or a minimum of 2 years of work OR
customer service related experience preferred.
Job Specific Technical Skills & Competencies
- Demonstrated ownership attitude and customer centric response
to all assigned tasks - Basic
- Verbal and written communication skills -Intermediate
- Attention to detail ensuring accuracy - Basic
- Ability to work in a high volume, fast paced environment
managing multiple priorities - Basic
- Analytical Thinking - Basic
- Judgment/ Decision Making - Basic
Environmental / Work Schedules / Other
- Travel Requirements: Travel Occasionally
Employment Practices
Travelers 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 our
differences.
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
http://careers.travelers.com/life-at-travelers/benefits/.
Keywords: The Travelers Companies, Inc., Orlando , Workers Compensation Claim Representative Trainee, Other , Orlando, Florida
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