Senior Claims Examiner, Cyber

About TMHCC

TMHCC (Tokio Marine HCC) has been serving the specialty insurance industry for 50 years and offers more than 100 products to commercial customers worldwide.

Senior Claims Examiner responsible for analyzing coverage and processing complex claims under the applicable policy form, communicating with stakeholders, providing training and guidance to less experienced claims staff, and ensuring compliance with Claims Department workflows.

• Review submitted claims for coverage and determine coverage status under the applicable policy.
• Investigate increasingly complex claims and coverage issues.
• Draft action plans, coverage recommendations, and obtain required management approval for authority in excess of designated levels.
• Establish and revise claim reserves based on claim developments and counsel liability assessments within designated authority.
• Draft coverage determination letters, including reservation of rights and denial letters.
• Obtain and update information from defense counsel, coverage counsel, and insureds.
• Update claims diary to reflect activity.
• Authorize settlements within settlement authority provided by the Claims Manager.
• Review, approve, and reimburse the insured for legal, expert/vendor invoices, and settlements.
• Maintain claim files by accurately documenting all communications and activities.
• Communicate with brokers or reinsured clients to obtain necessary information for claims processing.
• Attend mediations and arbitrations for reinsurance clients as needed.
• Train, mentor, and assist other claims staff in resolving claims issues and making lower‑level decisions within departmental policies and procedures.
• Approve claims correspondence, requests for authority and claim payments within designated authority levels for less experienced staff.
• Assist in managing the workflow of other members of the claims department.
• Maintain quality, quantity, and response time standards of the business unit and the Company.

• Planning: develop work plans, establish timelines, assign resources, and meet deadlines.
• Communication: convey team or work unit results and recommendations to management and clients.
• Cost Management: improve existing business processes and implement new ones to increase productivity.
• Business Controls and Policies: comply with corporate policies, report control breakdowns, and conduct all activities safely.
• People Management: supervise assignments, train personnel, and review performance.

Minimum 4‑year bachelor's degree in a related field, or equivalent education and/or experience.

An active adjuster license is required in the state of residence or other designated home state at the time of hire, and must be maintained as current. Employees without a license at hire must obtain one within six (6) months. Additional state licenses may be required based on business need.

Minimum 6 years of relevant and progressive professional experience. Ability to apply knowledge of principles, practices, and procedures. Advanced organizational and analytical skills, with experience managing multiple tasks simultaneously.

• Intermediate proficiency in Microsoft Office (Excel, Access, PowerPoint, Word, Teams).

• Travel up to 10% of time may be required.
• Work outside core business hours may be required.
• May require a valid driver’s license, remaining stationary for extended periods, and moving up to 10 pounds.
• Must be able to operate a computer and adjust focus to read a computer screen.

Locations:
Atlanta, GA | New York, NY | Encino, CA | Chicago, IL. Hybrid work schedule; remote if candidate does not reside near an office location.

Competitive salary and employee benefit package including 6% 401(k) match, 20 days of PTO and 2 floating days, paid parental leave, and other benefits.

Salary range for New York, NY & Encino, CA is $115,000 – $188,000 annually. Compensation may vary based on location, experience, education, and skill level.

TMHCC is an equal‑opportunity employer and is committed to ensuring equal pay opportunities for equal work regardless of color, race, sex, national origin, sexual orientation, gender identity, gender expression, religion, age, veteran status, disability, pregnancy, citizenship status, genetic information, or any other basis protected by federal, state, or local pay equity laws.