Senior Claims Specialist, Workers Compensation

Marketing Statement

About Tokio Marine:

Tokio Marine has been conducting business in the U.S. market for over a century and we are licensed in all states, Puerto Rico and the District of Columbia, and write all major lines of Commercial Property and Casualty Insurance. We provide unique insurance and risk management tools from our experienced staff of account executives, underwriters and loss prevention engineers and fair and timely claim settlement from a skilled team of claim professionals. We work with major brokers and leading independent insurance agents throughout the United States to serve the world's largest and most distinguished organizations.

We are committed to creating value for our customers by providing ANSHIN (safety, security and peace of mind). We strive to be creative and passionate as we work towards our long-term success.

Tokio Marine Holdings is Japan's oldest, and one of the largest property and casualty insurers. Founded in 1879, TMNF operates worldwide in 47 countries. With annual revenues of approximately $50 billion and an A.M. Best rating of A++, one of the highest in the industry, we are one of the top 20 insurance providers worldwide.

Job Summary

Process Workers Compensation Medical and Indemnity Claims, monitor Workers Compensation cases and direct attorney and outside vendors assigned to these claims.

Essential Job Functions

• Confirm coverage and policy information.

• Establish proper loss reserve, negotiate loss settlement (when applicable) and bring cases to resolution.

• Maintain control of outside vendors/attorneys and their expenses by directing assignments to them and limiting their scope to maximize cost effectiveness while minimizing delays in claims handling.  Such vendors/attorneys must not be used unless pre-approved by the department manager.

• Maintain compliance with Workers' Compensation procedure and requirements established by regulatory authorities.

• Pursue Workers' Compensation liens and subrogation when appropriate.

• Maintain compliance with claims practice rules and internal instructions.

• Keep manager advised of significant developments in claims.

• Answer correspondence and inquiries promptly from brokers/agents, insureds, claimants, doctors, attorneys, outside vendors, TMA employees, etc.

• Responsible for complying with proper internal controls as necessary to conduct job functions and/or carry out responsibilities and/or administrative activities at Company.

Qualifications

• College Degree Preferred

• 5 to 10 years of experience handling Workers' Compensation claims for a major insurance carrier

• Must have applicable state licensing or the ability to obtain.

• Knowledge of Workers' Compensation policy coverages

• Knowledge of coding related to claims technical matters

• Knowledge of legal, medical terms and meanings, civil and agency laws and related fields which may come within the purview of Workers' Compensation claims

• Ability to negotiate settlement/resolution of claims in a timely and reasonable fashion

• Proficient in Microsoft office

• Good oral and written communication skills

Salary range $115,000 to $120,000. Ultimate salary offered will be based on factors such as applicant experience and geographic location. Our company offers a competitive benefits package and bonus eligibility on top of base.

TMA believes the perfect candidate is more than just a resume. If you don't meet every single requirement, but are still interested in the job, we encourage you to apply.

Benefits:

We offer a comprehensive benefit package, which includes a generous 401K match. Our rich history of outstanding results and growth allow us to focus our business plan on continued growth, new products, people development and internal career opportunities.  

EEO Statement

Tokio Marine Management is an Equal Opportunity Employer. In order to remain competitive we must attract, develop, motivate, and retain the most qualified employees regardless of age, color, race, religion, gender, disability, national or ethnic origin, family circumstances, life experiences, marital status, military status, or sexual orientation.