Role Description The Claims Support and Administrative Coordinator is responsible for supporting the claims team. The individual assists claimants, responds to inquiries, provides administrative support on claim files, prepares reports, and provides data and information to other departments, and manages a small caseload of title clearance matter files to a final resolution with supervisor oversight. Essential Duties and Responsibilities - Facilitate initial communication between claims and claimants. - Notify active agents of any new claims received unless there are extenuating circumstances. - Responsible for sending acknowledgement letters to appropriate parties. - Create monthly, or as needed, claim reports. - Provide legal research support to claims team when applicable. - Assist claims in conducting legal research to assist in case preparation. - Assist with drafting department policies and procedures. - Organize and maintain file system, correspondence, legal research, and other records. - Assist with requested claim audits. - Ensure deadlines are met. - Attend a conference, training session, or webinar related to the title industry to stay current. - Conduct thorough investigation on assigned low to medium difficulty level claim files, gather data, analysis of title policy and other products, and provide a recommendation for the best resolution for the claim. - Communicate with agent, if appropriate, of any sizeable loss to be paid on a file. - Examine title and develop strategy for resolution of claim in most cost-effective manner. - Determine need to retain defense counsel to defend the company or its insured in litigation and engage outside counsel with required approvals. - Evaluate liability and establish recommendations for settlement and expense reserves. - Resolve claims that do not require the defense of the company or that are covered claims through investigation, corrective documents, negotiation, or payment. - Draft agreements and corrective documents for review and approval by appropriate senior manager or, if appropriate, Claims Management Committee. - Review and approve invoices for costs and attorneys' fees. - Evaluate claims for recoupment options. - Review files assigned as part of company reserve process and update financial reserves accordingly. - Draft educational and training materials for seminars and present at seminars. - Support team to educate and train agents on claim concerns and how to avoid claim issues. Competencies - Achievement Focus: Demonstrates persistence and ability to overcome obstacles. Measures self against standard of excellence. Recognizes and acts on opportunities. Sets and achieves challenging goals. Takes calculated risks to accomplish goals. - Communications: Exhibits good listening and comprehension skills. Expresses ideas and thoughts in written and verbal form. Keeps others adequately informed. Selects and uses appropriate communication methods. - Managing Customer Focus: Develops new approaches to meeting customer needs. Establishes customer service standards. Monitors customer satisfaction. Promotes customer focus. Always calm and respectful in difficult situations. - Planning and Organization: Integrates changes smoothly. Plans for additional resources. Prioritizes and plans work activities. Sets goals and objectives. Uses time efficiently. Works in an independent and organized manner. - Problem Solving: Develops alternative solutions. Gathers and analyzes information skillfully. Identifies problems in a timely manner. Resolves problems in early stages. Works well in group problem solving situations. Decisive and accountable. Qualifications - Paralegal with one to three years related experience and/or training in title insurance or real estate industry preferred. - Read, analyze and interpret business, professional, technical or governmental documents. - Write reports, business correspondence and procedure manuals. - Effectively present information and respond to questions from managers, customers and the public. - Solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. - Highly proficient in Microsoft Suite and internet research. - Paralegal certification. Supervisory Responsibilities This job has no supervisory responsibilities. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the workplace is typically moderate. This position is a remote position. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. - While performing the duties of this job, the employee is regularly required to sit. - The employee is frequently required to use hands to finger, handle, or feel and talk or hear. - The employee is occasionally required to stand and walk. - The employee must be able to occasionally lift and/or move up to 10 pounds. - Specific vision abilities required by this job include close vision.

Role Description - Highly motivated and growth-oriented. - Excited by the prospect of building a tech-driven claims organization. - Passionate adjuster who cares about the customer and their experience. - Empathetic; exercises empathy and patience towards everyone interacted with. - Sense of urgency at all times, without working at all hours. - Creative; finds the right exit ramp for the resolution of claims in the insured's best interest. - Enjoys conflict; believes it should be conversational rather than adversarial. - Curious; wants to know the whole story to make informed decisions early. - Anti-status quo; takes action to improve processes. - Communicative; values sharing thoughts and ideas. - Possesses a sense of humor; understands the challenges of claims work. Qualifications - Minimum of 3 years’ experience with motor claims, including commercial and motor trade. - Experience in fraud within the motor space. - Proven background in credit hire negotiation. - Ability to deal with delegated authority and client philosophies. - Cert CII (or willingness to work toward it). - Ability to analyze and evaluate complex data and make sound decisions based on established guidelines, policies, and procedures. - Curious and motivated by problem solving and questioning the status quo. - Desire to engage in learning opportunities and continuous professional development. - Willingness to travel for client and claims needs. Requirements - Experience in commercial motor and motor trade claims – repair, capture, intervention, third-party & property damage. - Experience in credit hire negotiations. - Ability to handle claims from cradle to grave. - Attention to detail and ability to provide quality interactions with stakeholders, clients, and customers to high standards. - Excellent customer service skills. - Strong organizational skills and ability to prioritize workload. - Ability to work to system-driven SLAs and workflows. - Strong communication skills – both written and oral. - Comfortable working in a fluid role in a fast-paced environment. Benefits - Generous health-insurance package with nationwide coverage, vision, & dental. - 401(k) retirement plan with employer matching. - Competitive PTO policy – we want our employees fresh, healthy, happy, and energized! - Generous family leave policy after 8 months of continuous work. - Work from anywhere to facilitate work-life balance. - Apple laptop, large second monitor, and other quality-of-life equipment. - Listen to feedback to enhance and improve upon the challenges of an adjuster and the claims role. - Work toward reducing and eliminating administrative work from the adjuster role. - Foster a culture of empathy, transparency, and empowerment in a remote-first environment.

Role Description This position is responsible for entering paper and/or electronic claims into the claims system and examining and determining whether to return, request additional information, deny or pay claims following organizational policies and procedures after entry. After the appropriate training, incumbents are expected to meet the minimum levels for quality and production as measured by the Claims Department. Essential Responsibilities - Accurately examine, interpret and enter claims; resolve edits and first/second level suspense utilizing the claims processing system. - Perform necessary research and effectively make decisions to properly adjudicate claims utilizing processing manual. - Identify and communicate problems relevant to the claims processing system and the processing manual and/or guidelines. - Adhere to all established standard operating procedures. - Support continuous improvement by identifying process improvements and/or quality enhancements. - Initiate and respond to written and verbal communications from internal and external sources. - Perform Claim Adjustments of initial claims for internal and external adjustment reasons, resolving claims suspensions resulting from claim adjustments. - Resolve Medicare Secondary Payor (MSP) edits/audits/reason codes. - Perform other duties as the supervisor may, from time to time, deem necessary. Qualifications - High School Diploma or GED - 1 year of data entry experience, including accurate keyboard skills - Proficient with PCs and in Windows based environments; including Microsoft Office (Word, Excel, Outlook) - Demonstrated analytical skills - Strong verbal and written communication skills - Strong interpersonal skills Preferred Qualifications - Knowledgeable of medical terminology, procedure and denial codes Requirements - The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive. - Background Investigation: If you are selected for this position, you must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing documentation must be cleared prior to hire. Most positions are subject to additional Identity Proofing, Fingerprinting and additional Background Investigation screening conducted by the Federal Government to be granted Enterprise User Administration (EUA) system logical access after you begin your employment. Your continued employment is contingent upon the outcome of the complete additional screening criteria required for the position which must find that you meet the applicable government customer's requirements (e.g., suitable for access to CMS information and information systems), as well as any additional investigation which may be required throughout your employment. If you are found not suitable, your employment may be subject to corrective action, up to and including immediate termination of employment. - Identity Documentation: You must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents. Note: Employment Authorization Cards (EAD) are not a substitute for Visas or U.S. Permanent Resident Cards. Benefits - Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire - Short- and long-term disability benefits - 401(k) plan with company match and immediate vesting - Free telehealth benefits - Free gym memberships - Employee Incentive Plan - Employee Assistance Program - Rewards and Recognition Programs - Paid Time Off and Paid Sick Leave Company Description Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.

Title: Senior Workers' Compensation Claim Representative Location: CA - Diamond Bar CA - Irvine Full time Hybrid 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 170 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 $70,400.00 - $116,200.00 What Is the Opportunity? This role is eligible for a sign-on bonus. This position is eligible for a hybrid schedule. Employees may work up to 2 days per week at their primary residence. This position will office out of the Diamond Bar or Irvine locations. Under general supervision, manage Workers' Compensation claims with lost time to conclusion and negotiate settlements where appropriate to resolve claims. Coordinate medical and indemnity position of the claim with a Medical Case Manager. Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues. The claim may involve minor sprains/ minor to moderate surgery. The Injured worker is working modified duty and receiving ongoing medical treatment. The injured worker has returned to work, reached Maximum Medical Improvement (MMI) and is receiving PPD benefits. File will close as soon as the PPD is paid out. Independently handles all assigned claims up to and including most complex where Injured worker (IW) remains out of work and unlikely to return to position. Employer is unable to accommodate the restrictions. The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality. IW has been released to work with permanent restrictions and job is no longer available. IW is receiving Vocational Rehabilitation. Claims that have been reopened for additional medical treatment on more complex files. Injuries may involve one or multiple back, shoulder or knee surgeries, knee replacements, claims involving moderate to complex offsets, permanent restrictions and/or fatalities. Claims on which a settlement should be considered. What Will You Do? - Conduct investigations, including, but not limited to assessing policy coverage, contacting insureds, injured workers, medical providers, and other parties in a timely manner to determine compensability. - Establish and update reserves to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions. - Manage files with an emphasis on file quality (including timely contact and proper documentation and proactive resolution of outstanding issues). 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. - 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, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation). - Develop strategies to manage losses involving issues of statutory benefit entitlement, medical diagnoses, Medicare Set Aside to achieve resolution through the best possible outcome - Collaborate with our internal nurse resources (Medical Case Manager) in order to integrate the delivery of medical services into the overall claim strategy. - Prepare necessary letters and state filings within statutory limits. Pursue all offset opportunities, including apportionment, contribution and subrogation. - Evaluate claims for potential fraud. Proactively manage inventory with documented plans of action to ensure timely and appropriate file closing or reassignment. - Proactively manage moderate to complex 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. May use structured settlement/annuity as appropriate for the jurisdiction. Apply deep technical expertise to assist in the resolution of highly complex claims. Mentor other Claim Professionals - Participate in Telephonic and/or onsite File Reviews. Respond to inquiries – verbal and written. Keep injured worker apprised of claim status - Act as technical resource to others. - Participate in Telephonic and/or onsite File Reviews. Respond to inquiries – verbal and written. Keep injured worker apprised of claim status. Act as technical resource to others. Engage specialty resources as needed. - Performs other assigned duties which may include: Applies deep technical/subject matter expertise to assist in the resolution of complex claims. Acts as an independent mentor to other Claim Professionals. May be dedicated to and apply skills necessary to manage special account relationships (sensitive or complex). May primarily manage a specialized inventory of Workers’ Compensation claims. - Acts as an independent mentor to other Claim Professionals Applies deep technical/subject matter expertise to assist in the resolution of complex claims - Acts as an independent mentor to other Claim Professionals - 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. - Maintain Continuing Education requirements as required. - Perform other duties as assigned. What Will Our Ideal Candidate Have? - Education/Course of Study: Work Experience: - Analytical Thinking: Identifies current or future problems or opportunities; analyzes, synthesizes and compares information to understand issues; identifies cause/effect relationships; and explores alternative solutions that support sound decision-making. - Communication: Expresses, summarizes and records thoughts clearly and concisely orally and in writing by applying proper content, format, sentence structure, grammar, language and terminology. - Ability to effectively present file resolution to internal and/or external stakeholders. - Negotiation: Advanced evaluation, negotiation and case resolution skills. - Ability to understand alternatives, influence stakeholders and reach a fair agreement through discussion and compromise. - General Insurance Contract Knowledge: Interprets policies and contracts, applies loss facts to policy conditions, and determines whether or not a loss comes within the scope of the insurance contract. - Principles of Investigation: Intermediate investigative skills including the ability to take statements. - Follows a logical sequence of inquiry with a goal of arriving at an accurate reconstruction of events related to the loss. - Value Determination: Advanced ability to determine liability and assigns a dollar value based on damages claimed and estimates, sets and readjusts reserves. - Settlement Techniques: Advanced ability to assess how a claim will be settled, when and when not to make an offer, and what should be included in the settlement offer package. - Legal Knowledge: Thorough knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. - Medical knowledge: Intermediate knowledge of the nature and extent of injuries, periods of disability, and treatment needed. - WC Technical: - Advanced ability to demonstrate understanding of WC Products and ability to apply available resources and technology to resolve claims. - Demonstrate a clear understanding and ability to work within jurisdictional parameters within their assigned state. - Advanced knowledge, understanding and application of state, federal and regulatory laws and statutes, rules of evidence, chain of custody, trial preparation and discovery, court proceedings, and other rules and regulations applicable to the insurance industry. - Customer Service: - Advanced ability to build and maintain productive relationships with our insureds and deliver results with optimal outcomes. - Teamwork: - Advanced ability to work together in situations when actions are interdependent and a team is mutually responsible to produce a result. - Planning & Organizing: - Advanced ability to establish a plan/course of action and contingencies for self or others to meet current or future goals. What is a Must Have? - High school diploma or equivalent. - 2 years Workers Compensation claim handling experience. What Is in It for You? - Health Insurance: Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment. - Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers. - Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays. - Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs. - Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.