Senior Workers' Compensation Claim Representative - Diamond Bar, CA
Job Overview
Employment Type
Full-time
Compensation
Type:
Salary
Rate:
Range $60,000.00 - $75,000.00
Work Schedule
Standard Hours
Benefits
Health Insurance
Dental Insurance
Paid Time Off
Performance-based cash incentive
Sign-On Bonus
Hybrid work option
Professional Development
Job Description
Travelers is a leading property casualty insurance company with over 170 years of experience and a strong reputation for taking care of customers, communities, and employees alike. Known for its culture of innovation and collaboration, Travelers offers a dynamic and supportive work environment where employees are encouraged to succeed and make a meaningful impact. The company is committed to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and Caregivers, providing opportunities to those with the necessary skills and qualifications to thrive in their careers. This global insurance provider offers a comprehensive compensation package including an annual... Show More
Job Requirements
- High school diploma or equivalent
- Minimum of 2 years Workers Compensation claim handling experience
- Ability to obtain and maintain required Insurance License(s) within three months of employment
- Commitment to ongoing continuing education as mandated
- Strong analytical and communication skills
- Ability to negotiate settlements and manage complex claims
- Proficiency in interpreting insurance policies and applicable laws
- Capacity to collaborate with medical and legal specialists
- Willingness to work in a hybrid setting in Diamond Bar or Irvine, CA
- Military affiliation preferred but not required
Job Qualifications
- High school diploma or equivalent
- Minimum of 2 years of Workers Compensation claim handling experience
- Strong analytical thinking to identify and solve problems
- Excellent oral and written communication skills
- Advanced negotiation and case resolution abilities
- Knowledge of insurance contracts, principles of investigation, value determination, and settlement techniques
- Thorough understanding of state, federal, and regulatory laws affecting insurance
- Intermediate medical knowledge regarding injuries and treatments
- Advanced Workers Compensation product knowledge and ability to apply jurisdictional guidelines
- Strong customer service and teamwork skills
- Effective planning and organizing capabilities
Job Duties
- Conduct investigations including assessing policy coverage and contacting insureds, injured workers, medical providers, and other parties
- Establish and update claim reserves to reflect exposure and document rationale
- Manage files focusing on quality, timely contact, documentation, and proactive issue resolution
- Develop strategies to manage statutory benefit entitlement, medical diagnoses, and Medicare Set Aside to achieve effective resolution
- Collaborate with internal nurse resources to integrate medical services into claim strategy
- Prepare letters and state filings within statutory limits and pursue offset opportunities such as apportionment, contribution, and subrogation
- Evaluate claims for fraud and manage moderate to complex litigation to drive optimal outcomes
Job Qualifications
Experience
Mid Level (3-7 years)
Job Location
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