Specialty Claims Coordinator

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. 

For over 50 years, HCC Life Insurance Company, operating as Tokio Marine HCC – A&H Group, has been at the forefront of medical stop loss insurance. In addition to traditional stop loss, we offer captive and Taft-Hartley stop loss solutions, Organ & Tissue Transplant insurance and MedPlus insurance. Tokio Marine HCC – A&H Group is rated A++ (Superior) by A.M. Best Company and benefits from the financial stability of its parent company, Tokio Marine HCC.

 Position Summary:

Under general supervision, assists the Specialty Claims department in all administrative and support functions to ensure the efficient operation of the department.

Key Responsibilities:

• Assist the Specialty Claims Manager in the efficient operation of the department through implementation of administrative and support functions of the department.
• Oversee and manage workflow for the department for efficient processing of referrals.
• Maintain a database for recording and reporting cost containment activities through claim re-pricing and expenses related to re-pricing. This includes, but is not limited to, data entry functions, regular updates, documents results received, and inputting cost savings records. The database must be maintained in both PA system and in a spreadsheet.
• Process referrals and questions. Educate clients and provide necessary customer service. Ascertain what additional information might be needed from producers, vendors, and providers and follow-up on this missing information. Conduct general problem-solving as issues arise with internal and external clients.
• Screen all incoming calls to the department.
• Review Specialty Claims referrals for accuracy and provides the necessary look-up codes. Process the referrals to outside vendors and tracks results. Responsible for keeping accurate and up-to-date records.
• Prepare internal and external ad hoc reports as needed on a monthly basis. Distribute these reports to all required parties.
• Assist with preparation and updating policies and procedures for the workflow between departments and with vendors.
• Maintain a log of expenses for the department. Follow through and resolve any account receivable issues. Keep the department manager informed of accounts receivable or expense concerns.
• Access in-house resources including Actuarial, Underwriting, and Marketing departments to assist in attaining business goals.
• Understand and interpret employer plans of health coverage and excess insurance policies.

Education, Experience & Knowledge:

• 5 years of relevant and progressive experience in area of specialization
• Possess and have ability to apply knowledge of principles, practices, and procedures
• Solid written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy
• Advanced organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously
• Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word)
• Overtime hours may be required to fulfill job responsibilities
• May be required to remain stationary for extended periods of time
• May be required to move up to 10 pounds
• Must be able to operate a computer and other devices
• Close vision and ability to adjust focus, such as required to read a computer screen

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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