http://careers.travelers.com/go/Buffalo-NY-Claims-Jobs/33355/ View Buffalo NY Claims Jobs at Travelers Tue, 09 Feb 2010 23:02:26 GMT en-us /view/client/travelers/images/home_logo.gif http://careers.travelers.com/go/Buffalo-NY-Claims-Jobs/33355/ 720
Job Title:

Certified Professional Coder

Job ID:

787954

Location: NY-Buffalo

Available Openings:

Committed. 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.



***This job requisition is used for continuous recruitment and may not reflect an open position at this time.



Summary



Determines payment owed on largest, most complex First Party Medical medical bills.

Provides Service Center staff with expert technical support for issues related to fee schedules, state rules, clinical and billing edits, and contract rules.



Primary Duties & Responsibilities



The First Party Medical Bill Management system electronically routes exceptional bills to MRT work queue. Bills are exceptional due to risk, large dollar amounts, and bill complexity.

Process First Party Medical bills routed by system:

Review High Level Evaluation and Management (E&M) Bills to determine if coded appropriately.



Apply rules to exception bills that the computer system can not determine.

Review bills that the system has identified as potential billing duplicates.

Review and reprise large hospital itemized bills.

Apply payment policy rules to medical supplies and medicine.

Review the reports on complex surgery and determine the appropriate amount owed.



Education/Work Experience



4 year college degree preferred

Knowledge of AMA, CPT, HCPC and medical terminology



Maintain Coding Certification and membership in either American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA).



Other



Cognitive and computational skill.

Ability to process high volumes accurately



Travelers is an equal opportunity employer. We actively promote a drug-free workplace.]]> http://careers.travelers.com/job/Buffalo-Medical-Bill-Analyst-Job-NY-14201/418829/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W_RSS http://careers.travelers.com/job/Buffalo-Medical-Bill-Analyst-Job-NY-14201/418829/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W_RSS
Job Title:

Claim Rep, Auto Damage

Job ID:

790273

Location: NY-Buffalo

Available Openings:

Committed. 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.



PLEASE NOTE: THIS IS A PIPELINE OPENING DESIGNATED FOR ONGOING RECRUITMENT EFFORTS.



SUMMARY:

Handle 1st and 3rd party Personal Insurance and Business Insurance claims. Manage claims for automobiles, a variety of heavy, specialty and mobile equipment and non-auto related property damage (i.e.: mail box, fence, and indirect damages such as down time and business interruption.) Claims will have varying degrees of complexity and severity (I.e.: coverage issues, multi-car, fatalities, liability determination, etc).



PRIMARY DUTIES:

- Handle all types of vehicles including automobiles, and a variety of heavy and mobile equipment (i.e. Cranes, tractor trailers, construction, agricultural equipment) at every severity level including other property damage i.e.: guard rails, mail boxes and any property within the vehicle.

- Handle vehicle claims with varying degrees of complexity and severity (I.e.: coverage issues, multi-car, fatalities, liability determination, etc).

- Review and analyze coverage and apply policy conditions, provisions, exclusions and endorsements, pertinent to a variety of vehicle damage claims. Recognize and apply how jurisdictional issues impact the claim (i.e.: negligence laws, financial responsibility/limits, immunity, etc.) Manage deductibles and coverage limits.

- Contact appropriate parties to obtain relevant facts necessary to determine coverage, causation/damages, nature and extent of injuries and exposure with respect to the various vehicle coverage provided.

- Investigate facts to establish negligence, determine liability, other sources of recovery and negotiate resolutions as appropriate. Manage fire, theft and other claims that require specialized investigation and utilization of internal and external experts in accordance with local laws.

- Request the appropriate inspection type based on the details of the loss to effectively and efficiently resolve the claim (i.e.: conciergeclaim, appraisal, heavy equipment, property task assignment). When a Total Loss is determined, authorize payment through the Total Loss representative.

- Conduct damage management including properly managing the repair process i.e.: mitigating storage, rental, early tow to salvage and other related expenses by working closely with appraisers, rental facilities, body shops, repair facilities and other vendors.

- Establish timely and maintain appropriate claim and expense reserves.

- Develop and continually update a plan of action including maintaining an effective diary to bring the claim to resolution in a timely manner. Manage file inventory by utilizing an effective diary system and documenting claim file activities in accordance with established procedures.

- Write denial letters, Reservation of Rights and other routine and complex correspondence to insured-s and claimants.

- Determine settlement amounts based on independent judgment, estimation of actual cash value and replacement value, appraisals, application of applicable limits and deductibles.

- Negotiate and convey claim settlements within authority limits to insureds.

- Meet all quality standards and expectations per Best Practices.

- Comply with state specific regulations.

- Provide quality customer service to meet the needs of the insured, claimant, all internal and external customers. Fulfill specific service commitments made to certain accounts, as outlined in Special Account Communication (SAC).

- Recognize and forward appropriate files to subject matter experts i.e.: SIU, engineer, staff/general counsel, heavy equipment, construction, property, CAT mgmt, fire investigator, Independent Adjuster, and accident reconstruction for their review and consult. Identify subrogation opportunities; determine appropriateness of the demand and negotiate adverse subrogation and arbitration.

- Handle litigation on appropriately assigned cases. Develop litigation plan with staff or panel counsel, and track and control legal expenses; Review conciliations and prepare submissions for arbitration hearings.

- May participate with Auto ERT during extreme weather events.-

- Effectively manage multiple competing priorities to ensure timely payment, follow-up and claim resolution.



EDUCATION/COURSE OF STUDY:

College degree or equivalent business experience



CERTIFICATES/DEGREES:

Adjusters license (where applicable)



COMMUNICATION SKILLS:

Strong verbal and written communication skills



COMPUTER SKILLS:

Hardware and software skills to utilize and leverage claim and adjusting technology



OTHER:

Medical terminology knowledge (helpful)

Customer service and empathy skills

Solid analytical and decision making skills

Math skills

Excellent negotiation skills and ability to effectively handle conflict

Strong organization and time management skills

Ability to multi-task and to adapt to a changing environment

Ability to effectively handle conflict

Attention to detail ensuring accuracy.

Strong investigative skills and creativity to achieve optimal resolution



Travelers is an equal opportunity employer. We actively promote a drug-free workplace.]]> http://careers.travelers.com/job/BUFFALO-Claim-Rep,-Auto-Damage-Job-NY-14201/558391/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W_RSS http://careers.travelers.com/job/BUFFALO-Claim-Rep,-Auto-Damage-Job-NY-14201/558391/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W_RSS
Job Title:

Unit Manager/2nd shift

Job ID:

792568

Location: NY-Buffalo

Available Openings:

Committed. 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.



Position requirements: The qualified candidate will be based out of the Buffalo, NY office. This position is for the 2nd shift (to midnight) including both weekend days. Part of the work week may involve working from home.



SUMMARY:

- Lead and direct claim support/customer service team, or first party auto claim handling team ensuring efficient and effective implementation of strategic initiatives and operational goals.

- Coach, mentor and facilitate development of team members to maximize individual and organizational performance.

- Evaluate and manage performance objectives relative to quality, productivity and other office standards/goals as well as providing individual and team feedback on an ongoing basis.

- Recognizes all factors of performance, business results and personal effectiveness.



PRIMARY DUTIES:

Attract, Retain and Develop World Class Talent:

- Work with management to establish and implement a strategic staffing strategy; establish and maintain high recruiting standards to acquire high caliber of people with diverse skills and backgrounds.

- Motivate team members by providing training, honest constructive performance feedback and counseling.

- Effectively utilize reward system to distinguish top performers and significant achievements.

- Recognize all factors of performance, business results and personal effectiveness.

Provide Compelling Claim Services

- Employ proper claim handling techniques to protect the integrity of our brand and providing consistent service quality and streamlined processes to add value for our customers.

- Develop & execute a strategic file management plan that achieves optimal file resolution and business results.

- Establish and monitor individual team goals based on the overall office objectives and adherence to Best Practices.

- Conduct quality file reviews per office/ best practices guidelines (Keep and Close).

- Coordinate work activity to ensure appropriate deployment of resources to maximize productivity and ensuring the highest level of service.

- Implement strategies and initiatives to improve file quality, customer service and manage costs.

- Anticipate operational challenges and plan proactively to address.

Partner for Mutual Success

- Build and maintain partnerships with colleagues and business partners to promote an enterprise culture.



EDUCATION/COURSE OF STUDY:

- College degree preferred or equivalent work experience



WORK EXPERIENCE:

- Claim or operations experience (3-5 years)

- Production Management experience a plus

- Customer Service experience

- Call Center Metrics experience a plus



OTHER:

- Computer Skills including Microsoft Office



- Span of Control approximately 10-20 if claim support, 8-10 if first party auto, and may vary based on:

Team composition

Support or customer service functions

Claim Customer Service

Dispatch Unit

Field Operations Unit

First Party Auto (Keep and Close)

Glass Unit

Salvage Unit

Scanning Center

Experience of Staff



Leading the Business:

- Executes Business Strategy

- Leads Change

- Drive Results/Promotes Enterprise Culture

- Leading Others:

- Attract Top Talent

- Maximize individual and Organizational Performance

- Holds Others Accountable Aligns Rewards

- Creates and Sustains a Dynamic Workplace

Leading Self:

- Exhibits Courage, Conviction and Creditability

- Communicates Effectively and Influence Others

- Applies Critical Thinking

- Demonstrate Self-Awareness



Travelers is an equal opportunity employer. We actively promote a drug-free workplace.]]> http://careers.travelers.com/job/BUFFALO-Unit-Manager-2nd-shift-Job-NY-14201/728933/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W_RSS http://careers.travelers.com/job/BUFFALO-Unit-Manager-2nd-shift-Job-NY-14201/728933/?utm_source=J2WRSS&utm_medium=rss&utm_campaign=J2W_RSS