Senior Workers' Compensation Claims Representative
Mitsui Sumitomo Marine Management (U.S.A.), Inc. | Cincinnati | 7/3/2017
Mitsui Sumitomo Insurance Group (MSIG) is one of the world’s top ten property/casualty insurance carriers with over 38,000 employees worldwide. MSIG insures large multinational and domestic companies, and offers comprehensive global insurance programs. Our US subsidiary, Mitsui Sumitomo Marine Management (MSMM), currently has an opportunity available for Senior Claims Representative – Workers’ Compensation in our Cincinnati Ohio office.
SUMMARY: To adjust assigned workers’ compensation claims within delegated limits of authority, conduct timely and thorough investigations, and complete fair and equitable claim settlements.
- Analyze the nature of the claim to determine required investigation and handling. Determine and identify coverage issues or questions of compensability in accordance with Claims Handling Guidelines.
- Perform timely and thorough investigations in an effort to comply with all jurisdictional requirements and/or entitlements.
- Conducts an informed case analysis to address claim entitlements. Initiate reserve changes within assigned authority, makes recommendations to supervisor or manger where assigned authority is exceeded
- Manage, control and negotiate timely and equitable claim payments and settlements in accordance with jurisdictional and fair claims practices requirements and company policy and procedures.
- Investigate, evaluate and resolve moderate level litigated files including all aspects of litigation management in accordance with the Claims Handling Guidelines.
- Maintain current case diary and ensure appropriate file documentation.Responsible for completion and/or submission of claim forms and reports as required by outside agencies.
- Investigate and evaluate recovery potential. Conduct timely and thorough subrogation investigation in accordance with company policy and procedures. Timely completion and referral of all claims involving recovery potential.
- Service the claim needs of our customers, including insureds, claimants, brokers etc. in accordance with company policy and procedures.
Experience/Education
- Bachelor's degree (B. A.) preferred; 5+ years related WC claims experience preferred Completion of insurance and/or claims courses preferred (IAA, AEI, CPCU) Knowledge of multi-state WC laws. Adjuster licenses will be required.
We are committed to providing the highest quality products and services to our customers. We are dedicated to a set of core values that directs our actions and decisions: Corporate Quality - Customer Focus - Integrity - Clear and Open Communication - Teamwork and Accountability - Committed to maintaining a positive work environment and culture for our employees, family and community.
Mitsui Sumitomo offers a wide range of benefits and is an equal opportunity employer.
If you have the required skills and experience and are interested in working in a challenging environment, please email your resume with salary requirements.
JOB OVERVIEW
Pay
Industry
Category
Career Level
Competitive salary and comprehensive benefits package.
Claims, Workers' Compensation
Experienced (Non-Manager)
Mitsui Sumitomo Marine Management (U.S.A.), Inc. (“MSMM”) is a United States subsidiary of MS & AD Insurance Group Holdings, Inc., one of the world’s top property/casualty insurance carriers with over 38,000 employees in more than 39 countries & regions worldwide.
MSMM manages the business affairs of three U.S. commercial property/casualty insurance companies: Mitsui Sumitomo Insurance Company of America, Mitsui Sumitomo Insurance USA Inc. and Aioi Nissay Dowa Insurance Company of America, all rated A+ (Superior) by A.M. Best Company (for the latest rating, access www.ambest.com).
MSMM specializes in providing commercial property and casualty insurance products and related services to customers throughout the U.S.
In joining MSMM, you are becoming part of a worldwide team dedicated to:
- Making a lasting contribution to the enrichment of society by bringing security and safety to people and businesses around the world through the sale and servicing of its insurance products;
- Realizing customer satisfaction by working to provide the finest products and services to consistently meet our clients’ growing needs; and
- Meeting our shareholders’ expectations and strengthening their trust in us by continuously improving our business.
We value each employee’s unique set of skills and contributions and believe that each employee plays an important role in the success of MSMM.
MSIG refers to the MS&AD Insurance Group insurers underwriting coverage: Mitsui Sumitomo Insurance Company of America, Mitsui Sumitomo Insurance USA Inc. and Aioi Nissay Dowa Insurance Company of America. MS&AD Insurance Group, 15 Independence Boulevard, Warren, P.O. Box 4602, New Jersey 07059-0602.
© MSIG Holdings (Americas), Inc. All rights reserved.