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Job Description SummaryThis is an entry level position that requires satisfactory completion of required training to advance to Claim Representative - Specialty Liability position. This position is intended to develop skills for investigating, evaluating, negotiating and resolving 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.
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:
- Timely coverage analysis and communications with insured based on application of policy information, facts or allegations of each case. Consults with Unit Manager on use of Claim Coverage Counsel.
- Investigates each claim through prompt contact with appropriate parties such as policyholders, accounts, claimants, law enforcement agencies, witnesses, agents, medical providers and technical experts to determine the extent of liability, damages, and contribution potential. Takes necessary statements.
- 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.
- Verifies the nature and extent of injury or property damage by obtaining and reviewing appropriate records and damages documentation.
- Keeps effective diary management system to ensure that all claims are handled timely. At required time intervals, evaluates liability and damages exposure, and establishes proper indemnity and expense reserves.
- Utilizes evaluation documentation tools in accordance with department guidelines.
- Responsible for prompt, cost effective, and proper disposition of all claims within delegated authority.
- Negotiates disposition of claims with insureds and claimants or their representatives.
- Recognizes and implements alternate means of resolution.
- Maintains claim files, have an effective diary system, and document claim file activities in accordance with established procedures.
- May attend depositions, mediations, arbitrations, pre-trials, trials and all other legal proceedings, as needed.
- Updates appropriate parties as needed, providing new facts as they become available, and their impact upon the liability analysis and settlement options.
- Recognizes cases based on severity protocols to be referred timely to next level claim professional or Major Case Unit.
- Appropriately deals with information that is considered personal and confidential.
- Provides quality customer service and ensures file quality.
- Shares accountability with business partners to achieve and sustain quality results.
- Must secure and maintain company credit card required. [varies by job]
- 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.
- In order to progress to Claim Representative, a Trainee must demonstrate proficiency in the skills outlined above. Proficiency will be verified by appropriate management, according to established standards.
- High School Diploma or GED and one year of customer service experience OR Bachelor's Degree required.
Education, Work Experience, & Knowledge
- Bachelor's Degree preferred or a minimum of 2 years of work OR customer service related experience preferred.
Job Specific Technical Skills & Competencies
- Demonstrated ownership attitude and customer centric response to all assigned tasks - Basic
- Verbal and written communication skills -Intermediate
- Attention to detail ensuring accuracy - Basic
- Ability to work in a high volume, fast paced environment managing multiple priorities - Basic
- 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.