Lead Healthcare Claims Assistant

Tokio Marine HCC is a global industry-leading specialty insurance group, backed by the strength and stability of the Tokio Marine Group. Offering over 100 classes of specialty insurance, we empower clients to pursue opportunities confidently through our “Mind Over Risk” philosophy. More than an insurance company, we are an organization built on innovation, unity, and trust.

About the role

As a Lead Healthcare Claims Assistant, you will play a critical role in the claims team by managing claim intake flow and supporting claims operations. You will become part of a growing and evolving team with the ability to make immediate impact while working closely with your colleagues and taking ownership of critical issues relating to the overall claims operations. This is a great role for a self-starting independent thinker looking to leverage their skills in a fast-paced environment supporting a new team. As part of this opportunity, you will have an integral part in developing processes and identifying efficiencies in all parts of healthcare claims operations.

Responsibilities

• Manage claims intake email inbox and triage initial notices accordingly.
• Set up claim files by performing data entry, electronic data filing, sending out acknowledgment emails, and filing same to the electronic file.
• Book bordereaux data received in regular intervals.
• Respond to and manage loss run requests.
• Perform close activities and prepare reports on an as-needed basis.
• Electronically file additional correspondence and monitor claim activity for escalation to claims personnel.
• Input data into spreadsheets, databases, and other departmental systems.
• Draft, prepare, and process various types of correspondence including acknowledgment of new claims.
• Respond to general inquiries and relay basic information to internal and external business partners.
• Assist other claims personnel as needed during the claims process and ensure adherence to company claims policies and procedures.
• Assist in special projects such as file reviews, statistical studies, or workflow analysis.
• Perform other general clerical duties such as copying, filing, answering phones, and operating office equipment.

Requirements

• High School or GED required; college preferred.
• Adjuster licensed preferred.
• Prior healthcare or casualty experience strongly preferred.
• 7 years of relevant and progressive claims, administrative, clerical, or support experience.
• Ability to apply knowledge of principles, practices, and procedures with minimal supervision.
• Strong written and verbal communication skills with an emphasis on confidentiality and professionalism.
• Advanced organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously.
• Intermediate to advanced proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word).

Benefits

• Competitive salary and comprehensive benefits package.
• Strong learning culture with ongoing development opportunities.
• Opportunities for growth and career advancement.
• Comprehensive medical, vision, and dental coverage, with eligibility beginning on your first day of employment.
• Basic life and disability insurance.
• 401(k) plan with 6% company match.
• 20 days of PTO, two floating holidays, approximately 11 paid holidays, and volunteer time off.
• Paid parental leave.
• Access to our award-winning wellness program, including mental health services, fitness network membership, and a complimentary Headspace subscription.
• Student loan matching program.
• Employee discount program.

Pay

The pay range for this position is $29.90-$51.35/hr, which includes geographic adjustments, where applicable.

Schedule

Hybrid

Tokio Marine HCC is a leading specialty insurance group with offices in the United States, the United Kingdom, Europe, and other exciting locations. With the strength and stability that comes from being a member of the Tokio Marine Group, and more than fifty years of growth, profitability, and stability, we offer important insurance products that most people don’t even know exist.