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Tailor your resume to this Auto First Party Medical Claim Representative role.
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Tailor your resume to this Auto First Party Medical Claim Representative role.
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About the Role
As a Claim Rep, Auto First Party Medical (FPM), you will be responsible for handling first party medical claims from the first notice of loss through resolution/settlement and payment process. In this detail-oriented and customer-focused role, you will work closely with eligible parties, medical providers and attorneys to ensure claims are resolved efficiently while maintaining a high level of professionalism, empathy, and service throughout the claims handling process.
Responsibilities
- Review, investigate, and document Auto First Party Medical claims under limited supervision.
- Handle personal insurance claims with limited supervision and higher authority and begin to handle business insurance claims with direct supervision.
- Gather information from eligible parties, medical providers, and/or attorneys.
- Investigate and evaluate all relevant facts and information to determine coverage, causation/damages, medical necessity, treatment plans, and exposures.
- Proactively manage medical treatment based on the nature and extent of injury, mechanism of injury, type of treatment received or anticipated, and wage loss through case management and use of medical resources as needed.
- Ensure proper payment.
- Provide timely and professional communication to eligible parties, medical providers, attorneys, and internal stakeholders.
- Determine settlement amounts, negotiate and convey claim settlements to eligible parties, as appropriate.
- Maintain accurate records of claim activity in claim management systems.
- Demonstrate openness to continuous learning and adoption of emerging technologies, particularly in the areas of AI and digital transformation.
- Adapt to new technology implementations, system upgrades, and digital tool rollouts while maintaining productivity and service quality.
- Acquire and maintain relevant Insurance License(s) to comply with state and Travelers’ requirements within three months of starting the job.
- Perform other duties as assigned.
Requirements
- High School Diploma or GED required.
- One year of auto claim handling experience or comparable claim experience or successful completion of required Travelers Claim Representative training program.
Skills
- Claims management software proficiency
- Advanced Microsoft Office skills
- Enterprise technology systems and platforms proficiency
- Strong verbal and written communication skills
- Ability to convey information clearly and professionally
- Sound judgement and effective decision-making
- Exceptional customer service skills
- Commitment to providing a positive customer experience
- Strong attention to detail
- Organizational skills
- Ability to manage multiple tasks and prioritize effectively
- Demonstrated conflict resolution skills
- Ability to facilitate productive discussions and reach equitable outcomes
- Ability to manage stress
- Ability to navigate difficult situations
- Ability to maintain composure and professionalism under pressure
- Accountability for decisions
- Basic understanding of insurance principles and terminology
- Basic understanding of state insurance regulations
- Basic understanding of claim handling requirements
- Ability to quickly learn from experience
- Ability to apply learning to new situations with speed and flexibility
Location
- Nationwide
Work Type
- Full-time
Experience Level
- Two years of auto claim handling experience
- One year of auto claim handling experience or comparable claim experience or successful completion of required Travelers Claim Representative training program
Education Level
- Bachelor’s Degree
- High School Diploma or GED
Salary/Compensations
- $62,300.00 - $102,800.00
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, subject to an annual maximum.
- Paying it Forward Savings Program for employees with student loan debt, where Travelers makes an annual contribution to 401(k) when a student loan payment is made.
- Pension Plan 100% funded by Travelers.
- Minimum of 20 days Paid Time Off annually.
- Nine paid company Holidays.
- Wellness program with tools, discounts, and resources.
- Mental health program providing access to free professional counseling services, health coaching, and other resources.
- Matching Gift and Volunteer Rewards program to support charitable giving.
About the Company
- Taking care of our customers, our communities and each other.
- Travelers has maintained its reputation as one of the best property casualty insurers in the industry for over 170 years.
- A culture that is rooted in innovation and thrives on collaboration.
Equal Opportunity
- Travelers 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.
- In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.
- If you are a candidate and have specific questions regarding the physical requirements of this role, please send us an email so we may assist you.
- Travelers reserves the right to fill this position at a level above or below the included level in this posting.