Insurance Medical Claims Adjuster
7 days ago
Company Overview
Travelers Insurance is a leading provider of property casualty insurance in the industry for over 160 years. We pride ourselves on delivering exceptional customer service and maintaining a strong commitment to our customers, communities, and employees.
Salary
The estimated annual salary range for this position is $59,200.00 - $97,700.00, which reflects the scope, complexity, and location of the role as well as the skills, education, training, credentials, and experience of the candidate.
Job Description
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.
Key Responsibilities:
- Customer Contacts/Experience
- Deliver consistent service quality throughout the claim life cycle, including prompt contact, explaining the process, setting expectations, on-going communication, follow-through, and meeting commitments to achieve optimal outcome on every file.
- Coverage Analysis
- Review and analyze coverage and apply policy conditions, provisions, exclusions, and endorsements for assigned jurisdictions.
- Investigation/Evaluation
- Investigate 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.
- Reserving
- Evaluate claim and expense reserves to reflect overall claim exposure and manage file inventory and expense reserves by utilizing an effective diary system.
- Negotiation/Resolution
- Determine settlement amounts, negotiate and convey claim settlements within authority limits to insureds and claimants.
Requirements
To be successful in this role, you will need:
- An 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.
Benefits
We offer a comprehensive benefits program that includes health insurance, retirement plans, paid time off, wellness programs, and volunteer encouragement. We are committed to recruiting, retaining, and developing diverse talent and fostering an inclusive workplace.
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