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Claims Specialist- Senior Workers Comp

Location: Jersey City, NJ, United States
Date Posted: Apr 28, 2022

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Job Description

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:

Responsible for initial claim receipt and complete setup, investigation, damage assessment, evaluation and resolution of claims. 

Accountable for proper payout and quality of claim files.

Essential Job Functions:

• Establish and maintain a rapport with customer, injured party and medical provider to obtain information

• Obtain all relevant facts to determine coverage, liability or compensability on claim files

• Determine and analyze medical condition through investigation

 Utilize and manage experts to determine facts, damages and exposure, ensuring the value of the service is greater than the cost

 Work as a partner with defense counsel and ensure legal resources are used to obtain the best resolution on the claim

  Monitor medical progress and utilize medical management for indemnity control

 Evaluate information to assess proper resolution of claim and to determine appropriate and fair settlement

 Negotiate settlement based upon strategies and plans that ensure appropriate fair settlement of the claim

 Must have self-management skills to maintain and utilize all administrative functions of position

 Recognize and implement LAE reductions techniques

 Available for local and out-of-state travel to visit clients, maintain state licensing requirements

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


 Bachelor's degree preferred

 Three to five years Workers Compensation claims experience

 Knowledge of a specific line of business: workers' compensation and subrogation

 Ability to negotiate claims toward settlement and resolution

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.

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