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Claims Examiner I
Tokio Marine HCCClaims Examiner resolving claims by investigating losses at Tokio Marine HCC. Collaborating with clients and underwriters to ensure accuracy in claim processing.
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
claims investigationdata analysisinsurance coverage determinationclaims resolutionliability assessmentbenefits coordinationclaims reportingunfair claims settlement complianceinsurance principlesanalytical skills
Soft Skills
communication skillsconfidentialitytactdiplomacyorganizational skillsmultitaskingteam collaborationprofessional networkingproblem-solvingattention to detail
Tools & Technologies
Microsoft OfficeExcelAccessPowerPointWord
Certifications & Qualifications
High School DiplomaGED
Industry Keywords
claims managementinsurance industryclient guidelinesunderwriter guidelinesclaims volumesettlement agreementsloss ratiosclaims guidelineseducational workshopsspecial projects
About the role
Key responsibilities & impact- Resolves claims by investigating losses through the collecting and analyzing of data according to policy application and client/underwriter guidelines.
- Determine insurance coverage by examining claim information, policies, and other records and interview claimants and other providers.
- Maintain accurate system by collecting, analyzing, and summarizing information.
- Resolve questionable claims by investigation: comparing claims information with evidence.
- Settle claims by determining insurance carrier's liability, reaching agreement with claimant according to policy provisions.
- Coordinate benefits with other insurance carriers when possible to minimize loss ratios for the client and the company.
- Contribute to phone support by prompt and accurate answering.
- Record/update claims volume and activity in a bordereau for reporting as required by the client, director, or Accounting department.
- Maintain insurance product and the Company reputation by complying with claims guidelines and unfair claims settlement limitations.
- Maintain professional and technical knowledge by attending educational workshops and establishing professional networks.
- Perform special projects as required.
- Contribute to the team effort by accomplishing related tasks as needed.
Requirements
What you’ll need- Minimum High School or GED
- 2 Years Relevant and progressive claims or insurance experience
- 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)
Benefits
Comp & perks- Competitive salary and employee benefit package
- Strong learning culture
- Growth perspectives
- 6% 401K match
- 20 days of PTO and 2 Floating Days
- Paid parental leave
- An opportunity to love what you do