Claims Assistant

MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world’s top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging a 350-year heritage, MSIG USA brings financial strength, expertise, and a global footprint to offer commercial insurance solutions that address unique business risks.

Responsibilities

• Claims Administration & Regulatory Compliance
  • Prepare and complete all jurisdictionally required benefit notices accurately and within applicable regulatory timeframes (e.g., same-day or within 24 hours of check issuance, as required by the governing jurisdiction).
  • Complete all other assigned claim tasks within five (5) business days, or sooner as business needs dictate.
  • Ensure benefit notices are completed in time to meet same-day mailing deadlines.
  • Verify all documentation includes the language, forms, and attachments required by the applicable jurisdiction.
  • Identify and use the appropriate delivery method for claim notices (e.g., mail or email, where permitted by the jurisdiction).
• Documentation & Records Support
  • Assist with processing and tracking documentation related to claim activities.
  • Ensure completeness, accuracy, and timely routing of all required forms and supporting materials.
• Mail, Fax & Communication Management
  • Pick up, open, date-stamp, and process incoming mail daily.
  • Index and route mail to the document management system the same day for assigned adjusters.
  • Scan and distribute documents, including:
    • Medical, translation, copy, and expert invoices to the designated bill-review vendor
    • Med-legal reports to examiners, managers, and the R&C Manager
  • Manage outgoing mail, including general and certified mail, within established daily deadlines.
  • Identify and route undeliverable ("Not Found") mail to the designated escalation inbox the same day.
  • Prepare printed documents for mailing, including assembling and applying postage.
  • Maintain office equipment readiness (e.g., ensuring copiers are stocked with paper).
  • Monitor the fax inbox on a regular schedule and distribute incoming documents to the appropriate adjusters.
  • Respond to phone calls and emails by end of day; address after-hours communications promptly at the start of the next business day.
  • Manage toll-free/general inquiry calls and direct callers to the appropriate personnel.
• Litigation & Hearing Support
  • Log all hearing notices (e.g., mediation, trial, lien conference) received via mail into the litigation calendar and litigation log.
  • Assist with electronic filing and service processes, including:
    • Managing new file setups
    • Maintaining recurring diary entries in the claims system until claim closure
  • Participate in litigation committee meetings as scheduled.
  • Provide documentation to defense counsel with transmittal letters via the designated secure file-sharing platform.
• Tracking, Reporting & Vendor Coordination
  • Complete tracker forms for non-cashed checks within required timeframes.
  • Document communication attempts and escalate issues to examiners and management as appropriate.
  • Maintain and submit delay logs (including permanent disability delays, where applicable) to management on a regular schedule.
  • Support daily task tracking and ensure timely completion of assigned work.
  • Process subpoenas of records through the designated records-request platform.
  • Coordinate with vendors and internal stakeholders for document handling and processing.
• Team & Operational Support
  • Provide phone coverage shared among Claims Assistants.
  • Support managers with special projects as assigned.
  • Collaborate with adjusters and team members to ensure workflow efficiency and alignment.
  • Maintain strong organization and prioritization across high-volume, time-sensitive tasks.

Qualifications

• High school diploma required; Associate's or Bachelor's degree preferred.
• 1–3 years of administrative or claims support experience (insurance environment preferred).
• Knowledge of workers' compensation processes and regulatory requirements across multiple jurisdictions is a plus.
• Strong organizational skills and ability to manage jurisdiction-specific deadlines across a multi-state caseload.

Pay

$45,000 – $55,000 per year