Claims Support Associate

Claims Operations Associate

MSIG USA continues to grow! MSIG USA is the US-based subsidiary of MS&AD Insurance Group Holdings, Inc., one of the world's top P&C carriers and a global Class 15 insurer, with A+ ratings and a reach that spans 40+ countries and regions. Leveraging our 350-year heritage, MSIG USA brings the financial strength, expertise, and global footprint to offer commercial insurance solutions that address your business's unique risks.

The Claims Operations Associate supports the efficient administration of claims operations through claim processing, operational support, data integrity, vendor coordination, quality assurance, stakeholder management, and continuous improvement activities. This role serves as a key operational resource responsible for supporting day-to-day claims operations to ensure accurate processing, routing, and compliance. The position acts as a liaison between Claims Operations, Underwriting, Finance, Technology, business stakeholders, vendors, and automation partners to identify issues, manage exceptions, coordinate resolutions, and support ongoing process improvements. The role contributes to operational excellence by promoting data quality, customer service, workflow efficiency, and effective adoption of automation and process enhancements.

Claims Operations Support

• Support claim acknowledgment and related operational processing activities as needed.
• Coordinate with internal and external business partners to resolve operational issues and claim processing concerns.
• Prepare reports, maintain records, and support operational tracking and reporting requirements.
• Participate in special projects and other duties as assigned.

Escalation & Exception Management

• Monitor claims operations workflows to identify processing exceptions, delays, and operational issues.
• Investigate issues to determine root cause and recommend corrective action.
• Engage appropriate Claims, Technology, vendor, and business stakeholders to facilitate issue resolution.
• Communicate issue status, business impact, and resolution plans to affected parties.
• Track issues through resolution and ensure appropriate follow-up activities are completed.

Stakeholder Coordination

• Act as a liaison between Claims, Underwriting, Finance, Operations, Technology, and external service providers.
• Respond to inquiries regarding claims status, operational issues, exceptions, and workflow concerns.
• Facilitate communication and coordination among stakeholders to resolve operational challenges.
• Support Claims leadership by identifying and communicating operational trends, risks, process gaps, and opportunities for improvement.
• Escalate systemic issues requiring cross-functional review, decision-making, or corrective action.
• Partner with business and technology teams to ensure operational requirements are understood and supported.
• Coordinate stakeholder communication during process changes, automation initiatives, system enhancements, and operational transitions.
• Assist in gathering business requirements and feedback related to claims operations processes and technology solutions.

Vendor Administration & Financial Support

• Coordinate setup and maintenance activities for vendors providing services related to claim handling and claim resolution.
• Data review and linking of financials for feeds ingested by TPA partners. Maintain vendor records and support operational compliance requirements. Provide backup support for claims-related financial transactions and operational processing activities as needed. Reconcile operational data and vendor reporting to ensure accuracy and completeness.

Quality Assurance & Operational Governance

• Monitor operational performance metrics and service standards.
• Support compliance with departmental procedures and operational controls.
• Recommend corrective actions and process improvements based on operational findings.

Process Improvement & Transition Support

• Support the transition of new processes and activities, including documentation, training, and stabilization support.
• Partner with business, technology, and vendor teams to implement process improvements and operational enhancements.
• Drive continuous improvement initiatives focused on workflow efficiency, turnaround time, service quality, data accuracy, and customer experience.
• Participate in testing, validation, and implementation activities related to process improvements, automation initiatives, and system enhancements.

Qualifications

• High School Diploma or equivalent required
• Minimum two years of experience in claims operations, insurance operations, customer service, or related administrative functions.
• Insurance industry experience preferred.
• Strong analytical, communication, customer service, and problem-solving skills.
• Proficiency with Microsoft Office applications
• Experience supporting process improvement, automation, or operational change initiatives preferred.

It's an exciting time for our company and a great opportunity to join a financially sound and growing global insurance group!

It is the policy of MSIG USA to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, MSIG USA will provide reasonable accommodations for qualified individuals with disabilities.