Tokio Marine HCC (TMHCC) brings 50 years of service to the specialty insurance industry, today offering over 100 products to commercial customers in 180 countries around the world.
Organic growth and over 60 successful acquisitions have grown our 2022 Gross Written Premium (GWP) to $5 Billion.
Our workforce has grown to 4,300 worldwide ... big, but not so big that you cannot make a difference.
Our Good Company values, including integrity, empowerment, and commitment to customer service, and a culture of innovation, communication, and collaboration make TMHCC a great place to work.
TMHCC Stop Loss, a $2 Billion division within TMHCC, leads the way in providing medical stop loss insurance sold to employers.
Medical Stop Loss provides an added layer of insurance protection to employers who choose to self-fund their health benefit plans.
Self-funding can incur risks from catastrophic claims, and Medical Stop Loss insurance from Tokio Marine HCC is designed to protect employers from that risk.
Position summary:
Review, analyze, and determine claim documentation received for initial, supplemental or 50% notifications under the stop loss policy for incoming claims received electronically or by mail.
Demonstrate the ability to understand basic medical terminology and handle large reports with multiple claimants to determine monthly or YTD (Year to Date) reporting for claimants under the stop loss policy.
Key Responsibilities: Review monthly reports with claim forms over the Spec Deductible for claim reimbursement.
Identify claimants at 50% threshold for claim notification.
Meet production requirements.
Review incoming emails to determine the appropriate actions for incoming request.
Utilizing tool to apply procedures for current processes.
Demonstrate the ability to work in Spec Reports mailbox with limited knowledge of stop loss.
Input all claims department information into PA such claim status, appeals, policy and eligibility request into PA. Identify run out claims for monthly reporting.
Identify claimants with YTD (Year to Date) reporting for stop loss reimbursement.
Knowledge, Skills and Requirements Possess and have ability to apply 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 Proficient proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word) Minimum High School or GED Basic insurance knowledge Tokio Marine offers a competitive salary and benefits package, including: Generous paid time off (PTO), 12 paid company holidays, 401(k) Retirement Plan with 6% company match. Health and dental insurance, and vision plan available. Company-provided long-term disability and life insurance. Opportunities for advancement in a successful and growing organization. Flexible work schedules and a great work/life balance. Paid Parental Leave. Volunteer Time Off. Enjoy casual dress and work in a modern, comfortable office with free parking. Hybrid work schedule
The Tokio Marine HCC Group of Companies offers a competitive salary and employee benefits package.
We are a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals.
The Tokio Marine HCC Group of Companies is an equal opportunity employer.
Please visit www.tmhcc.com for more information about our companies.
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