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Senior Claims Administrator in Indianapolis, IN at Tokio Marine HCC

Date Posted: 4/4/2018

Job Snapshot

Job Description

Tokio Marine HCC – Medical Insurance Services (MIS) Group has an opening for a Senior Claims Administrator in Indianapolis, IN.

Under general direction, audits claims processed by the Claims Examiners for accuracy. The claims are selected for audit on a random selection basis and those claims that exceed individual Claim Examiner authority limits.


Relying on experience and knowledge, the Senior Claims Administrator is responsible for accomplishing the following assignments. These assignments reflect substantial variety and complexity and are broad in nature.

  • Review submitted claim documents for sufficient data, verifies that benefits were paid correctly and in accordance with appropriate plans and policies.
  • Responsible for documenting and tracking results in designated format and timeframes.
  • Assist manager in identifying trends, weaknesses, and strengths for insight to the team’s quality and understanding of the work. Includes developing training materials, and conducting training sessions with staff.
  • Assist supervisor with the claim appeal process which may include performing the necessary research, documenting the results of the research, forming a recommendation, and drafting correspondence. Approve appeals up to a set authority limit; anything above the authority limit will be referred to management for approval.
  • Assist supervisor with system procedures relating to adjustments, voids, cancellations, or reimbursements. Communicate with Accounting regarding: returned claims checks – due to wrong address info; as requested by the Claims department; or as submitted due to provider corrections.
  • Recommend changes to the Claims Procedural manual. Update manual as necessary with changes.

Job Requirements

Position Knowledge, Skills, and Requirements:


  • High school diploma or equivalent


  • Minimum of five years of relevant and progressive experience 


  • Possess and have ability to apply advanced knowledge of principles, practices, and procedures
  • Requires strong medical knowledge, including International Classification of Diseases (ICD), Current Procedural Terminology (CPT), HIPAA, and medical terminology
  • Ability to read and interpret documents such as Plan of benefits, contracts, claim reports, and procedural manuals
  • Excellent written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy
  • Advanced organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously
  • Intermediate proficiency and experience using Microsoft Office package (Excel, Access, PowerPoint, Word)

If your experience matches these requirements, please apply WITH A COVER LETTER INCLUDING SALARY REQUIREMENTS.

Tokio Marine HCC offers a competitive salary and employee benefit package. We are a successful, dynamic organization experiencing rapid growth and are seeking energetic and confident individuals to join our team of professionals. Tokio Marine HCC and its subsidiaries are equal-opportunity employers. Please visit for more information about our companies.


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