Claims Assistant

Position Summary

This role offers an opportunity to adjust and process member claims related to travel emergencies.

Key Responsibilities

• Evaluate received claims information for required details, issue follow up to claimant for any required information.
• Verify member policy coverage against the date of reported loss.
• Perform the initial and ongoing claims processing including setting up claim files, performing data entry, scanning documents, and preparing loss runs.
• Respond to and contact claimants, insured, and other related parties to obtain and relay basic information concerning the claim process.
• Create, compile, and handle various forms of correspondence, such as new claim acknowledgements, coverage determination letters etc.
• Complete the adjudication process and ensure claim decisions are accurately tracked in company software systems.
• Utilize your communication & collaboration skills to demonstrate an ability to manage multiple high priority tasks and provide timely updates to stakeholders.
• Participate in team learning opportunities and cross-training.
• Participate and assist in claims teams administrative tasks including raw data entry, monthly account reconciliation, client report requirements, quality checks and client documentation requirements.
• Provide ad hoc information as requested to support claim processing and/or special projects.

Performance Objectives

• Within the first 30 Days, be able to complete all company training and orientation and to participate in all claim’s specific trainings and meetings.
• Adjust 2 Claims each day and submit these claims for approval and final processing.
• Within the first 60 Days, start managing more complex claims independently, demonstrating competency and reliability. Adjust at least 3 Claims per day and submit these claims for approval and final processing.
• Within the first 90 Days, Achieve full competency in all aspects of the claim’s adjuster’s assistant role, handling tasks independently and accurately. Adjust at least 4 Claims per day and submit these claims for approval and final processing.
• Take shared ownership of TPA mailbox to respond to claims related queries from members.

Position Knowledge, Skills, And Requirements

• Education: High school diploma or equivalent. Associates degree is preferred.
• Experience: Minimum of two years of relevant and progressive administrative, clerical experience.
• Knowledge/Skills: Solid understanding of using Microsoft products. Basic understanding of software applications and web browsers. Possession of an Insurance Adjuster's License is preferred, or willingness to apply for a property and casualty adjuster's license. Experience using PeopleSoft Financials system is preferred but not required. Possess the ability to apply basic knowledge of principles, practices, and procedures. Strong written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy. Possesses organizational and analytical skills; demonstrates the ability to manage multiple tasks simultaneously. Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word).

Benefits

The Tokio Marine HCC Group of Companies offers a competitive salary and employee benefit package. We are a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals.

About the Company

The Tokio Marine HCC Group of Companies is an equal-opportunity employer. Please visit www.tmhcc.com for more information about our companies.