Workers Compensation Critical Claim Specialist

$83,300 - $137,400/Yr

Travelers - Diamond Bar, CA

Full-time - Mid Level

Diamond Bar, CA

Insurance Carriers and Related Activities

About the position

The position involves managing high exposure Workers Compensation claims, including catastrophic losses and complex cases. The role requires collaboration with specialty resources to ensure effective claim handling and resolution, while also maintaining communication with injured workers and stakeholders. The ideal candidate will have significant experience in Workers Compensation and possess strong analytical, negotiation, and communication skills.

Responsibilities

• Evaluate and manage high exposure Workers Compensation claims including catastrophic loss and complex claims.
• Collaborate with specialty resources to manage medical treatment and lost time benefits.
• Establish and update reserves to reflect claim exposure and document rationale.
• Develop strategies to manage losses involving complex issues of statutory benefit entitlement and injury severity.
• Facilitate timely claim resolution by leveraging mitigation opportunities.
• Act as a technical resource to others and maintain continuing education requirements.

Requirements

• High school diploma or equivalent required.
• Minimum of 5 years Workers Compensation experience.
• College degree highly preferred.
• Analytical thinking skills to identify and analyze problems or opportunities.
• Strong communication skills, both oral and written.
• Master negotiation skills for case resolution.
• Thorough knowledge of insurance contracts and policies.
• Advanced investigative skills for accurate reconstruction of events.
• Ability to determine liability and assign dollar value based on damages claimed.
• Knowledge of state, federal, and regulatory laws applicable to the insurance industry.
• Thorough medical knowledge of injuries and treatment needed.

Nice-to-haves

• Experience with structured settlements or annuities.
• Familiarity with Medicare Set Aside arrangements.

Benefits

• Health Insurance coverage from the first day of employment for employees and eligible family members.
• 401(k) matching contributions dollar-for-dollar up to the first 5% of eligible pay.
• Pension Plan that is 100% funded by Travelers.
• Minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
• Access to a wellness program with tools and resources for health and wellness goals.
• Mental health program providing access to free professional counseling services.
• Volunteer encouragement with a Matching Gift and Volunteer Rewards program.