Specific Claims Assistant II

Tokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products to commercial customers in 180 countries around the world.  Organic growth and over 60 successful acquisitions have grown our 2022 Gross Written Premium (GWP) to $5 Billion.  Our workforce has grown to 4,300 worldwide … big, but not so big that you cannot make a difference.  Our Good Company values, including integrity, empowerment, and commitment to customer service, and a culture of innovation, communication, and collaboration make TMHCC a great place to work. 

TMHCC Stop Loss, a $2 Billion division within TMHCC, leads the way in providing medical stop loss insurance sold to employers. Medical Stop Loss provides an added layer of insurance protection to employers who choose to self-fund their health benefit plans. Self-funding can incur risks from catastrophic claims, and Medical Stop Loss insurance from Tokio Marine HCC is designed to protect employers from that risk. 

*This role is remote*

Position Summary:

Under supervision, provides clerical assistance to Claims Examiners and Support staff. Performs routine tasks associated with the processing of stop-loss, reinsurance, and life/disability claims.

Key Responsibilities:

• Process life/disability claims by entering into system. Track the turn-around time to/from third-party administrators (TPAs) and/or carriers.

• Ensure forms needed are provided to auditors for processing claims.

• Enter received mail (initials and supplements) into document management system under the proper claimant.

• Input all claims department information into system such as received mail and log all mail received for production tracking purposes daily.

• Distribute the mail to the proper Auditor.

• Scan all letters and documents received to the proper claimant.

• Retrieve and return claimant files on a daily basis as needed by the Auditors.

• Create new claim folders when a new claim is entered into the system.

• Pull checks requested by auditors from all checks received.

• Run outstanding reports for supervisors for production purposes twice a day.

• Prepare files and ship the files to off-site storage. These are files that are finalized and are not needed on a regular basis. Pull off-site storage files as requested by Auditors.

Education, Experience & Knowledge:

• Minimum High School or GED

• Possess and have ability to apply basic knowledge of principles, practices, and procedures

• Good written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy

• Good organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously

• Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word)

Tokio Marine offers a competitive salary and benefits package, including: 

• Generous paid time off (PTO), 12 paid company holidays,

• 401(k) Retirement Plan with 6% company match.

• Health and dental insurance, and vision plan available.

• Company-provided long-term disability and life insurance.

• Opportunities for advancement in a successful and growing organization.

• Flexible work schedules and a great work/life balance.

• Paid Parental Leave.

• Volunteer Time Off.

• Enjoy casual dress and work in a modern, comfortable office with free parking.

• Hybrid work schedule

The Tokio Marine HCC Group of Companies offers a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals. The Tokio Marine HCC Group of Companies is an equal-opportunity employer. Please visit www.tmhcc.com for more information about our companies.

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