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Mitsui Sumitomo
Huntsville, AL | Full Time
$56k-68k (estimate)
8 Months Ago
Claims Representative
Mitsui Sumitomo Huntsville, AL
$56k-68k (estimate)
Full Time | Insurance 8 Months Ago
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Mitsui Sumitomo is Hiring a Claims Representative Near Huntsville, AL

Mitsui Sumitomo Marine Management U.S.A., Inc. is one of the world’s top ten property/casualty insurance carriers with over 40,000 employees worldwide.

Position Overview:

This position is responsible to adjust assigned claims within delegated limits of authority, conduct timely and thorough investigations, and complete fair and equitable claim settlements in accordance with MSMM Claim Handling Guidelines and/or requirements of principals regarding TPA business to ensure services are provided in a fair, equitable and timely manner.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

  • Receives new medical only workers’ compensation claim assignments of minor to moderate complexity level. Analyzes the nature of the claim to determine required investigation and handling. Determines and identifies compensability issues or questions of coverage in accordance with MSMM Claims Handling Guidelines.
  • Performs timely and thorough investigations in compliance with all jurisdictional requirements and/or entitlements.
  • Conducts an informed case analysis to initiate reserve changes within assigned authority and makes recommendations to supervisor or manager where assigned authority is exceeded.
  • Manages, controls and negotiates timely and equitable claim payments and settlements in accordance with jurisdictional and fair claims practice requirements and company policy and procedures.
  • Maintains current case diary and ensures retention of appropriate hard copy file documentation. Provides accurate claims system documentation as required by company claim manuals and procedures. Responsible for completion and/or submission of claim forms and reports as required by outside agencies.
  • May handle subrogation of claims within delegated limits of authority, including identification of responsible parties, preparation of claim notice, correspondence with carriers, and negotiation of settlement in accordance with MSMM Recovery Procedures.
  • Services the claim needs of our customers including insureds, claimants, brokers, etc., in accordance with company policy and procedures, and attends client visitations with underwriters and other parties to conduct presentations and reviews.
  • Maintains ongoing communication with all customers throughout the claims process in an effort to provide timely and appropriate claim status as appropriate and/or required by statutory regulation
  • Maintains full compliance with all regulatory Fair Claim Practices Acts and state and federal regulations.
  • Completes timely and accurate data reports to state reporting agencies to ensured full compliance with MSMM and regulatory requirement.
  • Maintains full compliance with all state licensing and continuing education requirements to ensure current and appropriate filing/standing of all adjuster licenses.

Education and/or Experience

  • High School Degree or G.E.D. is required. Bachelor’s degree (B. A.) from four-year college or university is preferred.
  • 2 years of industry experience, including ability to successfully verify coverage, appropriately establish reserves, complete investigations, and understand rules associated with state regulations

If you would like to apply for this position please send your resume to resumes@msigusa.com

The Company is an Equal Opportunity / Affirmative Action employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

Job Summary

JOB TYPE

Full Time

INDUSTRY

Insurance

SALARY

$56k-68k (estimate)

POST DATE

09/27/2023

EXPIRATION DATE

05/08/2024

WEBSITE

www.mitsui.com

HEADQUARTERS

Warren, New Jersey

SIZE

15,000 - 50,000

CEO

Connor Lennon

REVENUE

$10M - $50M

INDUSTRY

Insurance

About Mitsui Sumitomo

Founded in 1947, Mitsui is one of the most diversified and comprehensive trading, investment and service enterprises in the world, with 138 offices in 65 countries. Utilizing its global operating locations, network and information resources, Mitsui is multilaterally pursuing businesses ranging from product sales, to worldwide logistics and financing, to the development of major international infrastructure and other projects in the following sectors: Iron & Steel Products, Mineral & Metal Resources, Infrastructure Projects, Integrated Transportation Systems, Chemicals, Energy, Food, Food & Ret...ail Management, Healthcare & Service, Consumer Business, IT & Communication Business, and Corporate Development Business. Mitsui is actively pursuing opportunities for global business innovation around the world. More
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The job skills required for Claims Representative include Claim Handling, Subrogation, etc. Having related job skills and expertise will give you an advantage when applying to be a Claims Representative. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Claims Representative. Select any job title you are interested in and start to search job requirements.

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The following is the career advancement route for Claims Representative positions, which can be used as a reference in future career path planning. As a Claims Representative, it can be promoted into senior positions as a Claims Clerk III that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Claims Representative. You can explore the career advancement for a Claims Representative below and select your interested title to get hiring information.

If you are interested in becoming a Claims Representative, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Claims Representative for your reference.

Step 1: Understand the job description and responsibilities of an Accountant.

Quotes from people on Claims Representative job description and responsibilities

After careful review, the representative can approve, deny or escalate a claim.

02/12/2022: Buffalo, NY

As for eligible claims, they also calculate the benefit amount to pay out to policy holders.

01/22/2022: Duluth, MN

Determines claims coverage by examining company records. Responsible for calculating claims amounts and submitting claims for payment.

02/19/2022: Alexandria, LA

In this position, you will process insurance claims made by our customers, determining the amount of coverage they are eligible to receive through their current policy and authorizing payments.

01/06/2022: Salisbury, NC

Network with insurance agencies in the area to find leads on claims representative positions.

03/26/2022: Columbia, SC

Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.

Career tips from people on Claims Representative jobs

Interpret customer policies and coverages

03/17/2022: Indianapolis, IN

Organizational skills and Computer proficiency are highly needed.

12/30/2021: Monterey, CA

Negotiate settlements

02/02/2022: Omaha, NE

Maintain customer records

03/18/2022: Idaho Falls, ID

Wait for the claim to be processed.

03/23/2022: Parkersburg, WV

Step 3: View the best colleges and universities for Claims Representative.

Butler University
Carroll College
Cooper Union
High Point University
Princeton University
Providence College
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