Auto First Party Medical Claim Adjuster - New Hire Bonus
Company: The Travelers Companies, Inc.
Posted on: June 23, 2022
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 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.Compensation OverviewThe 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$52,600.00 - $86,900.00Target Openings1What Is the
Opportunity?New Things On The Horizon! Potential For a $5,000
This position is responsible for handling Personal and Business
Insurance First Party Medical claims from the first notice of loss
through resolution/settlement and payment process. This may include
applying laws and statutes for multiple state jurisdictions.
Provides quality claim handling throughout the claim life cycle
(customer contacts, coverage, investigation, evaluation, reserving,
negotiation and resolution) including maintaining full compliance
with internal and external quality standards and state specific
regulations. As part of the hiring process, this position requires
the completion of an online pre-employment assessment. Further
information regarding the assessment including an accommodation
process, if needed, will be provided at such time as your candidacy
is deemed appropriate for further consideration.
Travelers offers a hybrid work location model that is designed to
#LI-HybridWhat Will You Do?
- Customer Contacts/Experience:
- Delivers consistent service quality throughout the claim life
cycle, including but not limited to prompt contact, explaining the
process, setting expectations, on-going communication,
follow-through and meeting commitments to achieve optimal outcome
on every file. Fulfills specific service commitments made to
certain accounts, as outlined in Special Account Communication
- Coverage Analysis:
- Reviews and analyzes coverage and applies policy conditions,
provisions, exclusions and endorsements for assigned jurisdictions.
Verifies the benefits available, the injured party's eligibility
and the applicable limits. Addresses proper application of any
deductibles, co-insurance, coverage limits, etc. Confirms priority
of coverage (i.e. primary, secondary, concurrent) and takes into
consideration other issues such as Social Security, Workers
Compensation or others relevant to the jurisdiction.
- Investigates each claim to obtain relevant facts necessary to
determine coverage, causation/damages, medical necessity, treatment
plan, damages, and exposure with respect to the various coverages
provided through prompt contact with appropriate parties (e.g.
policyholders, medical providers and technical experts). This may
also include investigation of wage loss and essential services
claims. Takes recorded statements as necessary.
- Proactively manages 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. Proactively manages the process to
ensure proper payment, (i.e. review medical bills and medical
records for appropriateness of billing/fees and the services
rendered ensuring that all records have a determination of medical
necessity and causal relationship to the loss).
- Establishes timely and maintains appropriate claim and expense
reserves to reflect the overall claim exposure. Manages file
inventory and expense reserves by utilizing an effective diary
system, documenting claim file activities to resolve claim in a
- Determines settlement amounts, negotiates and conveys claim
settlements within authority limits to insureds and claimants. As
appropriate, writes denial letters, Reservation of Rights and other
necessary correspondence to insureds and claimants.
- May handle litigated files on appropriately assigned cases.
Develops resolution plan with staff or panel counsel, and track and
control legal expenses; Reviews conciliations and prepares
submissions for arbitration and/or mediation hearings. May also
attend arbitrations as Company witness.
- Insurance License:
- 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.
- Perform other duties as assigned.What Will Our Ideal Candidate
- Associate's Degree or Bachelor's degree with 2 years auto claim
handling experience preferred.
- Prior Auto First Party Medical experience preferred.
- Knowledge of medical terminology preferred.
- Demonstrated ownership attitude and customer centric response
to all assigned tasks.
- Attention to detail ensuring accuracy.
- Ability to work in a high volume, fast paced environment
managing multiple priorities.
- Keyboard skills and Windows proficiency, including Excel and
Word - Intermediate
- Verbal and written communication skills - Intermediate
- Analytical Thinking: Intermediate.
- Judgment/Decision Making: Intermediate.
- Negotiation: Intermediate.
- Insurance Contract Knowledge: Intermediate.
- Principles of Investigation: Intermediate.
- Value Determination: Intermediate.
- Settlement Techniques: Intermediate.
- Legal Knowledge: Basic.
- Medical Knowledge: Intermediate.What is a Must Have?
- High School Degree or GED with a minimum of one year auto claim
handling experience or successful completion of Travelers Claim
Representative training program required.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
- Wellness Program: The Travelers wellness program is comprised
of tools and resources that empower you to achieve your wellness
goals. In addition, our Life Balance program provides access to
professional counseling services, life coaching and other resources
to support your daily life needs. Through Life Balance, you're
eligible for five free counseling sessions with a licensed
- 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.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
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 level included in this posting.To learn more about our
comprehensive benefit programs please visit
Keywords: The Travelers Companies, Inc., Naperville , Auto First Party Medical Claim Adjuster - New Hire Bonus, Healthcare , Naperville, Illinois
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