Claims Examiner I

Job description

Job Title: Claims Examiner I Location: Encino, CA Reports to: Claims Manager Employment Type: Full time Job Req ID: 2026 Req Begin Date: 6 /12/2026 About TMHCC 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. Every policy we write is special, enabling our clients to do amazing things. From insuring the crops that feed us to the rock concerts that entertain us, to rescuing international travelers in trouble. Organic growth and over 60 successful acquisitions have grown our 2023 Gross Written Premium (GWP) to over $7.5 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. What We Offer Competitive salary and employee benefit package Strong learning culture Growth perspectives 6% 401K match 20 days of PTO and 2 Floating Days Paid parental leave An opportunity to love what you do Job Summary Resolves claims by investigating losses through the collecting and analyzing of data according to policy application and client/underwriter guidelines. Key Responsibilities Relying on limited experience and knowledge, this role is responsible for accomplishing the following assignments. These assignments are varied in nature and frequently non-routine. Determine insurance coverage by examining claim information, policies, and other records and interview claimants and other providers. Maintain accurate system by collecting, analyzing, and summarizing information. Resolve questionable claims by investigation: comparing claims information with evidence. Settle claims by determining insurance carrier's liability, reaching agreement with claimant according to policy provisions. Coordinate benefits with other insurance carriers when possible to minimize loss ratios for the client and the company. Contribute to phone support by prompt and accurate answering. Record/update claims volume and activity in a bordereau for reporting as required by the client, director, or Accounting department. Maintain insurance product and the Company reputation by complying with claims guidelines and unfair claims settlement limitations. Maintain professional and technical knowledge by attending educational workshops and establishing professional networks. Perform special projects as required. Contribute to the team effort by accomplishing related tasks as needed. Competencies Planning • Follow work plans, established timelines, and pre-defined goals for assigned work. • Meet commitments on deadlines. Communication • Develop strong customer focus and high service level relationship with clients. Cost Management • Perform work thoroughly in a cost-efficient manner and at a high productivity level. • Utilize company resources effectively. Business Controls and Policies • Comply with all corporate policies and procedures. • Take all reasonable steps to safeguard company assets against waste, loss, unauthorized use and misappropriation. • Report any breakdown in controls to a supervisor or manager. People Management • No people management responsibility • May assist in orienting and training less experienced employees. Position Knowledge, Skills, and Requirements Education Min/Preferred Minimum High School or GED Experience Years of Experience 2 Years Relevant and progressive claims or insurance experience in area of specialization Other 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 Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word) Superlative customer service skills Basic calculator knowledge