Auto First Party Medical Claim Representative

Travelers; Buffalo (NY); Sur place; USD 62 000 - 103 000; Plein temps

Avantages offerts par ce poste

Health Insurance

401(k) plan with company match

Résumé du poste

Travelers in Buffalo, NY is seeking a Claim Representative for Auto First Party Medical claims handling from first notice to resolution. You will work with medical providers, attorneys, and insured parties to ensure accurate coverage assessments and timely settlements.

The role requires a bachelor’s degree, auto claim experience, and an active adjuster license where applicable, with proficiency in claims software and MS Office. A customer-focused, detail-oriented approach is essential.

Qualifications

• Bachelor’s Degree.
• Two years of auto claim handling experience.
• Active adjuster license, where applicable.
• Proficient in claims management software, with advanced skills in Microsoft Office and enterprise technology systems and platforms.
• Strong verbal and written communication skills with the ability to convey information clearly and professionally.
• Ability to exercise sound judgement and make effective decisions.
• Exceptional customer service skills and commitment to providing a positive experience for customers throughout the claim process.
• Strong attention to detail and organizational skills; ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
• Demonstrated conflict resolution skills; ability to facilitate productive discussions and reach equitable outcomes.
• Ability to quickly learn from experience and apply it to new situations with speed and flexibility.

Responsabilités

• Review, investigate, and document Auto First Party Medical claims under limited 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 injury details and wage loss, ensuring 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.
• Maintain accurate records of claim activity in claim management systems.
• Adapt to new technology implementations and digital tool rollouts while maintaining productivity and service quality.
• Acquire and maintain relevant Insurance License(s) within three months of starting the job.
• Perform other duties as assigned.

Connaissances

Communication skills

Customer service

Attention to detail

Time management

Stress management

Decision making

Formation

Bachelor’s Degree

High School Diploma or GED

Active adjuster license

Outils

Claims management software

Microsoft Office

Enterprise technology systems

Description du poste

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

$62,300.00 - $102,800.00

Target Openings

4

What Is the Opportunity?

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.

What Will You Do?

• Review, investigate, and document Auto First Party Medical claims under limited supervision. Typically, will 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.

What Will Our Ideal Candidate Have?

• Bachelor's Degree.
• Two years of auto claim handling experience.
• Active adjuster license, where applicable.
• Proficient in claims management software, with advanced skills in Microsoft Office and enterprise technology systems and platforms.
• Strong verbal and written communication skills with the ability to convey information clearly and professionally.
• Ability to exercise sound judgement and make effective decisions.
• Exceptional customer service skills and commitment to providing a positive experience for customers throughout the claim process.
• Strong attention to detail and organizational skills; ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
• Demonstrated conflict resolution skills; ability to facilitate productive discussions and reach equitable outcomes.
• Ability to manage stress, navigate difficult situations, and maintain composure and professionalism under pressure while always taking accountability for decisions.
• Basic understanding of insurance principles and terminology, state insurance regulations and claim handling requirements.
• Ability to quickly learn from experience and apply it to new situations with speed and flexibility.

What is a Must Have?

• 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.

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 w