1st Party Medical Claim Representative

1st Party Medical Claim RepresentativeCommitted.  Competitive.  Constructing our Future.  That's Travelers. We are one of the leading insurance companies in the United States.  Our superior financial strength and consistent record of strong operating returns mean security for our customers - and opportunities for our employees.  You will find Travelers to be full of energy and a workplace in which you truly can make a difference. We are currently looking for a 1st Party Medical Claim Representative.  Please read on for more details regarding this position. JOB DESCRIPTION: Purpose:Investigate, evaluate, reserve, medical manage and resolve 1st party injury claims in accordance with Best Practices.  Provide quality claim handling and superior customer service on assigned claims, while engaging in management of payout.  Promptly manage claims by completing essential functions including contacts, investigation, damage/injury development, evaluation and reserving.  Must be able to work a variable schedule of hours including later shifts and/or weekends.   Responsibilities and Duties:- Provide voice-to-voice contact within 2 hours of first report. - Complete timely coverage analysis and communication with insured based on   application of policy information to facts or allegations of each case.  Consult with Unit   Manager on use of Claim Coverage Counsel.- Investigate each 1st party injury claims or first party medical benefits claims 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 injuries and damages.  Support other units as needed, i.e.,  Set   up appraisals, recognition of other exposures etc.  - Effectively utilize resources for specific activities required to properly manage claims   such as outside claim representatives, nurse consultants, SIU, IME/Peer review.  - Verify the nature and extent of injury by obtaining and reviewing appropriate records.- Keeps effective diary management system to ensure that all claims are handled timely. - Medically manage claims by regular interaction with the eligible injury party and or their   attorney and medical provider to establish causation of the injuries, medical necessity of   treatment and the treatment plan. - At required time intervals, evaluate exposure, and establish proper indemnity & expense   reserves.  Utilize evaluation documentation tools in accordance with department   guidelines. - Maintain claim files, have an effective diary system, and document claim file activities in   accordance with established procedures. - Identify subrogation opportunities for proper referral. - Appropriately deal with information that is considered personal and confidential.- Compliance with Claim Department's Best Practices and Financial Guidelines.- Assist the office in being highly productive by handling a workload consistent with   current workload standards and assisting in other areas, as needed.  Knowledge and Skills:4 year degree preferred Medical billing practices and prior claims handling experience preferredKnowledge of medical terminologyStrong organization, communication and customer service skills necessaryAbility to multi-taskTechnical skillsRelationship ManagementTechnology In addition to an exciting environment, we offer: * Competitive base salary with additional opportunities for variable pay through recognition programs and incentive awards * 401(k) with company match* Comprehensive health plans that include coverage for same sex/domestic partners* Strong work/family and employee assistance programs* Tuition reimbursement * Vacation Purchase Plan* Training/Development opportunities We are proud to provide comprehensive, high quality employee programs to meet employees' needs now and in the future, including a very competitive financial package. Explore what we have to offer.  For immediate consideration for this position, please click on the "Apply Now" button at the bottom of this posting.  Travelers is an equal opportunity employer. We actively promote a drug-free workplace.   Company: Travelers Companies, Inc.