Claims / Senior Claims Representative - Workers' Compensation

About the role

Western National is seeking a Workers’ Compensation Claims Representative to join our team.

Responsibilities

• Investigates, evaluates, negotiates, and resolves Workers’ Compensation claims as assigned.
• Handles moderate-to-high complexity claims within settlement authority.
• Ensures customer service excellence.
• Investigates and reviews policy forms, facts, and documents related to claims to make appropriate decisions on claims resolution.
• Affirms claim exposures and develops strategic action plans to drive efficient, fair, and cost-effective resolutions.
• Establishes and reviews proper reserves for each claim based upon thorough investigation, evaluation, and experience, maintaining appropriate reports to ensure current status of claims are clearly documented at all times.
• Provides direction to outside resources.
• Makes decisions guided by general instructions and practices requiring interpretation.
• Collaborates with cross-functional specialists – loss prevention, legal counsel, unit managers, special investigations unit, HR partners, safety directors, and fellow examiners – to support accurate determination of injury mechanisms and case strategy.
• Makes recommendations to solve more complex problems.
• Recognizes problems or situations that are new or lack clear precedent.
• Finds solutions using a systematic, multi-step approach.
• Develops improvements and innovations to enhance performance.
• Collaborates with all stakeholders involved in the claim lifecycle, including policyholders, agents, claimants, and internal partners.
• Handles regular contact with outside vendors.
• Travels on short notice for field work as required (e.g., scene investigations, inspecting property losses).
• Performs special projects and other duties as assigned.

Qualifications

• A minimum of two years of experience with Workers’ Compensation claims.
• Strong understanding of industry practices, standards, and claims concepts.
• Ability to multitask and solve problems.
• Ability to identify and investigate potential fraud indicators, including irregularities in medical treatment, billing practices, and reported injury details.
• Proficient oral and written communication skills.
• Strong negotiation and relationship-building skills.
• Analytical with the ability to exercise sound business judgment.
• Strong time management skills.
• Bachelor’s degree or related experience.

Benefits

Compensation overview: The full hiring range for this role is $59,200 - $94,000, annually. However, the base pay offered may vary depending on the job-related knowledge, skills, credentials, and experience of each candidate, as well as other factors such as the scope and location of the role. Candidates looking for compensation outside of the posted range are encouraged to apply and will be considered based on their individual qualifications and / or may be considered for other positions.

Culture and Total Rewards

Carefully consider your response to the following questions before applying. Your answers will help us determine if you are a good fit for this role. Please note that your responses are confidential and will not be shared with the hiring manager.

• How do you see yourself contributing to the team's success?
• What motivates you to excel in your work?
• What challenges do you think you can overcome in this role?

Western National has long been known as “The Relationship Company®” and caring for our employees is part of that relationship commitment. We value connectiveness, empowerment, and accountability, and we believe that our employees are our biggest asset.

Currently ranked as the 41st largest private company by revenue in Minnesota (Minneapolis/St. Paul Business Journal), Western National has earned accolades year-over-year as an employer of choice and garnered multiple awards for wellness in the workplace. Western National has also been named a Top Workplace by the Star Tribune for the past four consecutive years. In addition, the Group is consistently recognized as a Ward’s 50 property-and-casualty insurance company for its outstanding financial results.

Western National offers full-time employees a significant Total Rewards Package, including:

• Medical insurance plan options and other standard employee benefits, including dental insurance, vision benefits, life insurance, disability insurance, and more!
• Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA)
• 401(k) Plan (participants are eligible for 100% matching on the first 6% of their contributions)
• Wellbeing Program, including onsite fitness studio
• Paid Time Off – including holiday, vacation, and volunteer
• 100% company-paid tuition reimbursement for approved job-relevant coursework and access to The Institutes (Risk and insurance education)
• Paid parental leave
• Bonus opportunities

Western National believes in supporting balance between work and life by providing a flexible work environment, which includes a variety of hybrid and remote work arrangements designed to balance individual, job, department, and company needs.

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Western National provides employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.