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Job Description Summary
This is an entry level position that requires satisfactory completion of required training to advance to Claim Representative – Auto Liability position. This position is intended to develop skills for investigating, evaluating, negotiating and resolving Bodily Injury claims on losses of lesser value and complexity. 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.
Primary Job Duties & Responsibilities
- Completes required training program which includes the overall instruction, exposure, and preparation for employees to progress to the next level position. It is a mix of online, virtual, classroom, and on-the-job training. The training may require travel.
- The on the job training includes practice and execution of the following core assignments:
- Participates in on-going training sessions for the inside auto business.
- Works closely with Unit Manager or mentor to promptly resolve assigned claim.
- 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.
- Coverage Analysis :
- Reviews and analyzes coverage and applies policy conditions, provisions, exclusions and endorsements for moderate complexity Bodily Injury liability claims in 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 issues such as Social Security, Workers Compensation or others relevant to the jurisdiction. Consults with Unit Manager on use of Claim Coverage Counsel.
- Investigates each claim to obtain relevant facts necessary to determine coverage, the extent of liability, damages, and contribution potential with respect to the various coverages provided through prompt contact with appropriate parties (e.g. policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts). This may also include investigation of wage loss and essential services claims. Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation. Takes recorded statements as necessary. Utilizes evaluation documentation tools in accordance with department guidelines.
- Identifies resources for specific activities required to properly investigate claims such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators and to other experts. Requests through Unit Manager and coordinate the results of their efforts and findings.
- Recognizes cases based on severity protocols to be referred timely to next level claim professional or Major Case Unit.
- Establishes timely and maintains appropriate claim and expense reserves. Manages file inventory and expense reserves by utilizing an effective diary system, documenting claim file activities in accordance with established procedures to resolve claim in a timely manner.
- Determines settlement amounts, negotiates and conveys claim settlements within authority limits to claimants or their representatives. Recognizes and implements alternate means of resolution. As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to claimants.
- Handles both unrepresented and attorney represented claims.
- 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.
- High School Diploma or GED and one year of customer service experience OR Bachelor’s Degree required.
- Claims Handling/Insurance Experience Preferred
Job Specific Technical Skills & Competencies
- Demonstrated ownership attitude and customer centric response to all assigned tasks
- Demonstrated good organizational skills with the ability to prioritize and work independently
- Attention to detail ensuring accuracy
- Keyboard skills and Windows proficiency, including Excel and Word
- – Intermediate
- Verbal and written communication skills – Intermediate
- Analytical Thinking-Basic
- Judgment/Decision Making- Basic
Environmental / Work Schedules / Other
- Travel Requirements: Travel Occasionally
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.
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 http://careers.travelers.com/life-at-travelers/benefits/.