Claims Examiner

This is a hybrid position; the work location will be determined based on the selected candidate's proximity to one of our offices.

Duties / Responsibilities

• Provides customer service support to lenders, borrowers, insureds, claimants and all internal and customers.
• On occasion, takes claim information via telephone, fax, e-mail, or regular mail and creates a record of loss in the appropriate claim system.
• Verifies the claim coverage and reviews submitted claim forms for completeness and accuracy.
• Sends instructions to the field personnel regarding claim file issues.
• Utilizes the claim systems to assist customers with inquiries.
• Enters notes into the claim system regarding conversations or incidences with customers.
• Directs the efforts of the field adjuster.
• Provides any required functions relating to the Claims Department at the direction of management.
• Reviews reports from the field adjusters to ensure that the information and interpretation of the policy language are correct.
• Corrects any errors seen in the field reports.
• Interprets policy language and applies that policy language to loss situations.
• Enters claim and expense payments into the systems that are within their authority.
• Composes denial letters based upon the facts of the files as it relates to potential coverage issues.
• Provides any required functions relating to the Claims Department at the direction of management.
• Participation in audits of claim files.
• Works with other departmental internal personnel on special projects.
• Will be required to manage their own pending / case load.

Required Skills & Experience

About Tokio Marine Highland

Tokio Marine Highland Insurance Services (TMH) is a leading property and casualty underwriting agency. We offer a broad suite of tailored specialty risk management solutions, including private flood, fine art and lender-placed products. At TMH, it's all about our clients. Nationwide, our customers rely on our trusted, industry-leading coverages, supported by compliance expertise, superior claims management and the highest caliber of service.

Founded in 1962, TMH is a wholly owned company of Tokio Marine Kiln, one of the largest carriers in the Lloyd's of London insurance market and a member of the Tokio Marine Group. TMH has operating centers in Chicago, Il, Frisco, Texas, Miami, Fla., and South Pasadena, Calif.

If you're looking to advance your career, TMH is the perfect professional home. At TMH, you'll have a chance to innovate with the world's leading businesses, put your expertise into action on major projects, and work on game-changing initiatives. You'll also make long-lasting professional connections through sharing different perspectives, and you'll be inspired by the best.

Tokio Marine Highland, LLC (TMH) is an Equal Opportunity Employer. TMH's success depends heavily on the effective utilization of qualified people, regardless of their race, ancestry, religion, color, sex, national origin, sexual orientation, gender identity and / or expression, disability, veteran status, or any characteristic protected by law. As a company, we adhere to and promote equal employment opportunities for all.

Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is TMH's policy to provide reasonable accommodation when requested by qualified individuals with disabilities during the recruitment process, unless such accommodation would cause an undue hardship. To make an accommodation request, please contact humanresources@tmhighland.com.