ESIS Senior Claims Representative, WC

Senior Claims Representative

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we are dedicated to providing exceptional service and innovative solutions, and we are looking for passionate individuals to be part of our dynamic team. If you are eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

We are seeking a skilled Senior Claims Representative to enhance our team. Reporting to the Claims Team Leader, this role plays a vital part in investigating and managing claims promptly and equitably, in line with established best practices.

Key Responsibilities:

1. Conduct thorough investigations by reviewing claims and policy information to assess the extent of the policy's obligation to the insured.
2. Contact and interview insured individuals, claimants, witnesses, healthcare providers, attorneys, law enforcement, and other relevant parties to secure necessary claim information.
3. Prepare detailed reports on investigations, settlements, claim denials, and evaluations of parties involved.
4. Set reserves within authority limits and recommend reserve adjustments to the Team Leader.
5. Regularly review claim progress with the Team Leader, identifying challenges and suggesting possible solutions.
6. Prepare and present for review any unusual or potentially undesirable exposures to the Team Leader.
7. Collaborate on developing improved methods for handling claims and ensuring a timely and equitable settlement process.
8. Obtain necessary documentation, including releases, proofs of loss, or compensation agreements, and process claim payments efficiently.

Qualifications:

• A minimum of 4+ years of experience in handling workers' compensation claims, demonstrated by career progression in a current or similar organization.
• Ability to work independently with limited supervision while exercising sound judgment.
• Strong technical knowledge of claims handling processes and terminology.
• Excellent communication and interpersonal skills to interact positively with claimants, customers, brokers, attorneys, and other stakeholders.
• Comprehensive knowledge of the company's products, services, coverages, and policy limits, along with a solid understanding of claims best practices.
• In-depth knowledge of applicable state and local laws related to the line of business handled.
• Exceptional customer service skills and the ability to manage sensitive claims with care.
• Experience with California workers' compensation claims is preferred.

An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

The pay range for the role is $65,900 to $111,900. The specific offer will depend on an applicant's skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package.

ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS' innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients' unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry's broadest selections of risk management solutions covering both pre- and post-loss services.