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Company SummaryTaking 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 CategoryClaimTarget Openings1Job Description SummaryUnder general supervision, this position is responsible for investigating, evaluating, reserving, negotiating and resolving assigned serious and complex Workers Compensation subrogation claims. Provides quality claim handling throughout the claim life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific regulations. Provides consulting and training and serves as an expert technical resource to other claim professionals, business partners, customers, and other stakeholders as appropriate or required. This position does not manage staff.This position may be based 100% remotely or in one of our offices.Primary Job Duties & ResponsibilitiesCLAIM HANDLING:
Directly handle assigned severe claims.
Provide quality customer service and ensure file quality, timely coverage analysis and communication with insured based on application of policy information to facts or allegations of each case.
Directly investigate each claim through prompt and strategically-appropriate contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential.
Interview witnesses and stakeholders; take necessary statements, as strategically appropriate.
Complete outside investigation as needed per case specifics.
Verify the nature and extent of injury by obtaining and reviewing appropriate records and damages documentation.
Maintain claim files and document claim file activities in accordance with established procedures.
Manages litigated claims.
INFLUENCE AND COMMUNICATION:
Apply litigation management through the selection of counsel, evaluation and direction of claim and litigation. Provide guidance to underwriting business partners with respect to accuracy and adequacy of, and potential future changes to, loss reserves on assigned claims.
Recommend appropriate cases for discussion at roundtable.
Attend and/or present at roundtables/ authority discussions for collaboration of technical expertise resulting in improved recovery and expense management outcomes.
Develop and employ creative resolution strategies.
Responsible for prompt and proper disposition of all claims within delegated authority.
Negotiate disposition of claims with appropriate parties.
Recognize and implement alternate means of resolution.
Develop litigation plan with staff or panel counsel, including discovery and legal expenses, to assure effective resolution and to satisfy customers.
Actively and enthusiastically share experience and knowledge of creative resolution techniques to improve the claim results of others.
Utilization of Claim Legal Subrogation Counsel as needed.
Actively engage in the identification, selection and direction of appropriate internal and/or external resources for specific activities required to effectively evaluate claims, such as Liability, Risk Control, nurse consultants, Investigative Services, and other experts.
OTHER ACCOUNTABILITIES:
Utilize evaluation documentation tools in accordance with department guidelines.
Proactively review Claim File Analysis (CFA) for adherence to quality standards and trend analysis.
Utilize diary management system to ensure that all claims are handled timely.
At required time intervals, evaluate liability, damages and recovery potential.
Establish and maintain proper indemnity and expense reserves as appropriate.
Apply the Company's claim quality management protocols and metrics to all claims; document the rationale for any departure from applicable protocols and metrics with or without assistance.
Minimum QualificationsHigh School Diploma or GED required
High School Degree or GED required with a minimum of 5 years experience handling serious injury and complex liability claims required.
Education, Work Experience, & KnowledgeBachelor's Degree preferred. 10+ years claim handling experience with 5+ years experience handling serious injury and complex liability claims required.
Extensive working level knowledge and skill in various business line products.
Excellent negotiation and customer service skills.
Advanced skills in coverage, liability and damages analysis with expert understanding of the litigation process in both state and federal courts, including relevant case and statutory law and procedure; expert litigation management skills.
Extensive claim and/or legal experience and thus the technical expertise to evaluate severe and complex claims.
Able to make independent decisions on most assigned cases without involvement of supervisor.
Openness to the ideas and expertise of others and actively solicits input and shares ideas.
Thorough understanding of commercial lines products, policy language, exclusions, ISO forms and effective claims handling practices.
Demonstrated strong coaching, influence and persuasion skills.
Advanced written and verbal communication skills are required so as to understand, synthesize, interpret and convey, in a simplified manner, complex data and information to audiences with varying levels of expertise.
Can adapt to and support cultural change.
Strong technology aptitude; ability to use business technology tools to effectively research, track, and communicate information.
Job Specific Technical Skills & CompetenciesAnalytical Thinking - Advanced
Judgment/Decision Making - Advanced
Communication - Advanced
Negotiation - Advanced
Insurance Contract Knowledge - Advanced
Principles of Investigation - Advanced
Value Determination - Advanced
Settlement Techniques Advanced
Legal Knowledge - Advanced
Medical Knowledge - Intermediate
Environmental / Work Schedules / OtherOperates standard office equipment - Continuously
Sitting (can stand at will) - Continuously
Standing - Frequently
Use of Keyboards, Sporadic 10-Key - Continuously
Employment PracticesTravelers 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 (4-ESU@travelers.com) 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/ .
