Auto First Party Medical Claim Representative - Albany, NY

Military Spouse Corporate Career Network•Albany, NY

16h

About The Position

As an Auto First Party Medical Claim Representative, you will handle first-party medical claims from the first notice of loss through resolution, settlement, and payment. You will work with eligible parties, medical providers, and attorneys to resolve claims efficiently while providing professional, empathetic service. The role handles personal insurance claims with limited supervision and higher authority, and begins handling business insurance claims under direct supervision. The position requires obtaining and maintaining relevant insurance licenses within three months of starting.

Requirements

High school diploma or GED.
One year of auto claim handling experience, comparable claim experience, or successful completion of the required Travelers Claim Representative training program.
Acquire and maintain relevant insurance license(s) within three months of starting, as required by the state and Travelers.

Nice To Haves

Bachelor’s degree.
Two years of auto claim handling experience.
Active adjuster license, where applicable.
Proficiency in claims management software, with advanced skills in Microsoft Office and enterprise technology systems and platforms.
Strong verbal and written communication skills.
Sound judgment and effective decision-making ability.
Exceptional customer service skills and commitment to a positive customer experience.
Strong attention to detail and organizational skills, including the ability to manage multiple tasks and priorities in a fast-paced environment.
Conflict resolution skills and ability to facilitate productive discussions and reach equitable outcomes.
Ability to manage stress, navigate difficult situations, remain composed and professional under pressure, and take accountability for decisions.
Basic understanding of insurance principles and terminology, state insurance regulations, and claim handling requirements.
Ability to learn quickly from experience and apply learning to new situations with speed and flexibility.

Responsibilities

Review, investigate, and document Auto First Party Medical claims under limited supervision.
Gather information from eligible parties, medical providers, and attorneys.
Investigate and evaluate facts to determine coverage, causation and damages, medical necessity, treatment plans, and exposures.
Manage medical treatment based on the injury, mechanism of injury, treatment received or anticipated, and wage loss, using case management and medical resources as needed.
Ensure proper claim payments.
Communicate promptly and professionally with eligible parties, medical providers, attorneys, and internal stakeholders.
Determine settlement amounts, negotiate settlements, and convey settlements to eligible parties as appropriate.
Maintain accurate claim activity records in claim management systems.
Learn and adopt emerging technologies, including AI and digital transformation tools, and adapt to system upgrades and other technology implementations while maintaining productivity and service quality.
Acquire and maintain relevant insurance licenses within three months of starting, in accordance with state and Travelers’ requirements.
Perform other duties as assigned.