Fraud Claim Representative Jobs (NOW HIRING)

Who Are We?

Taking care of our customers, our communities and each other. That’s the Travelers Promise. By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 170 years. Join us to discover a culture that is rooted in innovation and thrives on collaboration. Imagine loving what you do and where you do it.

Compensation Overview

The annual base salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary for this position will be determined by a number of factors, including the scope, complexity and location of the role; the skills, education, training, credentials and experience of the candidate; and other conditions of employment. As part of our comprehensive compensation and benefits program, employees are also eligible for performance-based cash incentive awards.

Salary Range

Target Openings

What Is the Opportunity?

What Will You Do?

• 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.
• May manage litigated claims. Develops litigation plan with staff or panel counsel, track and control legal expenses Assures appropriate 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.
• Fulfills specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC) instructions, and inquiries from agents and brokers.
• Represents the company as a technical resource, attends legal proceedings as needed, act within established professional guidelines as well as applicable state laws.
• Provides quality customer service and ensures file quality.
• Shares accountability with business partners to achieve and sustain quality results.
• Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
• Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
• Resolve complex, severe exposure claims, using high service oriented file handling.
• 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.
• Perform other duties as assigned.

What Will Our Ideal Candidate Have?

• Bachelor's Degree.
• 2 years bodily injury liability claim handling experience.
• Commercial Claim handling experience.
• General knowledge and skill in claims handling and litigation.
• Basic working level knowledge and skill in various business line products.
• Demonstrated ownership attitude and customer centric response to all assigned tasks – Intermediate.
• Demonstrated good organizational skills with the ability to prioritize and work independently. - Intermediate.
• Demonstrated strong written, verbal and interpersonal communication skills including the ability to convey and receive information effectively.
• Intermediate.
• Attention to detail ensuring accuracy –Intermediate.
• Analytical Thinking- Intermediate.
• Judgment/Decision Making- Intermediate.
• Communication- Intermediate.
• Negotiation- Intermediate.
• Insurance Contract Knowledge- Intermediate.
• Principles of Investigation- Intermediate.
• Value Determination- Intermediate.
• Settlement Techniques- Intermediate.
• Medical Knowledge- Intermediate.

What is a Must Have?

• One-year bodily injury liability claim handling experience, or one year of liability claim experience, or successful completion of Travelers Claim Representative training program.

What Is in It for You?

• Health Insurance: Employees and their eligible family members – including spouses, domestic partners, and children – are eligible for coverage from the first day of employment.
• Retirement: Travelers matches your 401(k) contributions dollar-for-dollar up to your first 5% of eligible pay, subject to an annual maximum. If you have student loan debt, you can enroll in the Paying it Forward Savings Program. When you make a payment toward your student loan, Travelers will make an annual contribution into your 401(k) account. You are also eligible for a Pension Plan that is 100% funded by Travelers.
• Paid Time Off: Start your career at Travelers with a minimum of 20 days Paid Time Off annually, plus nine paid company Holidays.
• Wellness Program: The Travelers wellness program is comprised of tools, discounts and resources that empower you to achieve your wellness goals and caregiving needs. In addition, our mental health program provides access to free professional counseling services, health coaching and other resources to support your daily life needs.
• Volunteer Encouragement: We have a deep commitment to the communities we serve and encourage our employees to get involved. Travelers has a Matching Gift and Volunteer Rewards program that enables you to give back to the charity of your choice.

Employment Practices

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. 

In accordance with local law, candidates seeking employment in Colorado are not required to disclose dates of attendance at or graduation from educational institutions.

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.

To learn more about our comprehensive benefit programs please visit http://careers.travelers.com/life-at-travelers/benefits/.