Auto First Party Medical Claim Representative

Travelers • Albany, NY

8d • $62,300 - $102,800

About The Position

As a Claim Representative in Auto First Party Medical, you will handle first-party medical claims from initial notice of loss through resolution, settlement, and payment. The role works with eligible parties, medical providers, and attorneys to resolve claims efficiently and professionally, with empathy and a focus on service. Claims are reviewed, investigated, documented, evaluated, and negotiated under limited or direct supervision depending on the claim type. The position also requires obtaining and maintaining relevant insurance licenses within three months of starting.

Requirements

• High school diploma or GED.
• At least 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 licenses within three months of starting, as required by state and Travelers’ requirements.

Nice To Haves

• Bachelor’s degree.
• Two years of auto claim handling experience.
• Active adjuster license, where applicable.
• Proficiency in claims management software and 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 throughout the claim process.
• Strong attention to detail and organizational skills, including the ability to manage multiple tasks and prioritize in a fast-paced environment.
• Conflict resolution skills and the ability to facilitate productive discussions and reach equitable outcomes.
• Ability to manage stress, navigate difficult situations, and maintain composure, professionalism, and accountability under pressure.
• 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; handle personal insurance claims with limited supervision and begin handling business insurance claims with direct supervision.
• Gather information from eligible parties, medical providers, and attorneys.
• Evaluate relevant facts to determine coverage, causation, damages, medical necessity, treatment plans, and exposures.
• Manage medical treatment based on injury, mechanism of injury, treatment received or anticipated, and wage loss, using case management and medical resources as needed; ensure proper payment.
• Communicate promptly and professionally with eligible parties, medical providers, attorneys, and internal stakeholders.
• Determine settlement amounts, negotiate settlements, and convey them to eligible parties as appropriate.
• Maintain accurate claim activity records in claim management systems.
• Continue learning and adopt emerging technologies, particularly AI and digital transformation tools; adapt to technology implementations, system upgrades, and digital tool rollouts while maintaining productivity and service quality.
• Acquire and maintain relevant insurance licenses to meet state and Travelers’ requirements within three months of starting.
• Perform other duties as assigned.

Benefits

• Health insurance coverage for employees and eligible family members from the first day of employment.
• Dollar-for-dollar 401(k) match on contributions up to the first 5% of eligible pay, subject to an annual maximum.
• Paying it Forward Savings Program, with an annual Travelers contribution to the employee’s 401(k) when the employee makes a student loan payment.
• Pension Plan funded 100% by Travelers.
• At least 20 days of paid time off annually.
• Nine paid company holidays.
• Wellness program offering tools, discounts, resources, and caregiving support.
• Mental health program with access to free professional counseling services, health coaching, and other resources.
• Matching Gift and Volunteer Rewards program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED