ESIS ProClaim Senior Specialist
ESIS ProClaim Senior Specialist
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$ 103300 - 175700
1 Vacancy
Job Description
ESIS ProClaim is seeking an experienced Claims Specialist. In this role you will manage general liability claims and other lines.
Key Objective
Under the direction of the AVP and VP of Claims and Claims Team Leader you will review coverage investigates facts of thirdparty claims secure evidence assesses addresses subrogation/recovery/tenders and apportions liability and settles claims at the best outcome within established claim best practices guidelines and client instructions.
Responsibilities include but are not limited to:
- Determine coverage conducts a thorough investigation and may determine the extent of the policys obligation to the insured depending on the line of business.
- Maintain diary system to ensure each file is reviewed at a minimum of every 90 days.
- Effectively work with defense counsel and litigation working collaboratively as directed by the client.
- Ensure detailed 90day Claim Summary Reports are prepared and provide updates to the client on investigation potential settlement opportunities claim denials reservation of rights third party tenders and recommendations to present at claims review meetings.
- Posts loss and expense reserves in Claims system within authority limits and recommends reserve changes above authority to AVP and/or VP of Claims.
- Reviews progress and status of claims with claims leadership and discusses issues/opportunities/task and remedial actions.
- Prepares and submits to claims leadership all unusual or potentially undesirable exposures such as allegations of bad faith or unfair claim practice allegations.
- Assists Claims Leadership in formulating improvements in claims handling procedures.
- Assist and works with Partnership Leaders on delivering results attend meetings and claim reviews.
- Reviews and confirms claims professionals have secured the appropriate releases proofs of loss or compensation agreements and issues company drafts in payments for claims.
- Maintains claims with the appropriate file notes reports photos and documentation within the claim.
- Follows all company and regulatory compliance requirements.
- Updates claim timely with Medicare data and addresses Medicare reporting & interest.
Qualifications
- 10 or more years of experience as a claim professional and/or claims management with a high degree of specialized and technical competence in the handling of professional and general liability claims with emphasis on handson file and litigation management.
- P&C insurance adjuster license where required.
- Knowledge of insurance industry and claims handling concepts practices and procedures.
- Strong background and demonstrated ability in dealing with significant coverage matters.
- An understanding of insurance and legal principles.
- Knowledge of P&C Group coverage and services.
- Working knowledge of industry best practices and procedures.
- An ability to work independently.
- Excellent interpersonal communications and negotiation skills and an ability to deal with customers and business partners in a professional manner.
- Ability to make prompt reasoned decisions based upon detailed analysis of complex issues.
- Bachelors Degree or higher.
The pay range for the role is $103300 to $175700. The specific offer will depend on an applicants skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program. Chubb offers a comprehensive benefits package more details on which can be found on our careers website. The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.
ESIS a multiline ThirdParty Administrator (TPA) provides claims risk control & loss information systems toFortune 1000 clients across its North American platform.ESISprovides a full range of sophisticated risk management services including workers compensation claims handling; a broad spectrum of casualty insurance products such as general liability automobile liability products liability professional liability and medical malpractice claims handling; and disability management.
ESIS Specialty continually monitors measures and analyzes trends while working closely with clients to identify opportunities to positively impact their program costs. ESIS Specialtyapplies a balanced approach to claims handling and management and continually refines approach to be sure services are customized complementary and complete.
Required Experience:
Senior IC
Employment Type
Full-Time
