ESIS Claims Specialist, WC
ESIS Claims Specialist, WC
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
$ 72400 - 123100
1 Vacancy
Job Description
KEY OBJECTIVE:
Under the direction of the Claims Team Leader investigates and settles claims promptly equitably and within established best practices guidelines.
MAJOR DUTIES & RESPONSIBILITIES:
Duties may include but are not limited to:
Receive new assignments.
Reviews claim and policy information to provide background for investigation and may determine the extent of the policys obligation to the insured depending on the line of business.
Contacts interviews and obtains statements (recorded or in person) from insureds claimants witnesses physicians attorneys police officers etc. to secure necessary claim information.
Arrange for surveys and experts where appropriate.
Evaluates facts supplied by investigation to determine extent of liability of the insured if any and extend of the companys obligation to the insured under the policy contract.
Prepares reports on investigation settlements denials of claims individual evaluation of involved parties etc.
Sets reserves within authority limits and recommends reserve changes to Team Leader.
Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.
Timely and appropriate management of litigation files.
Assists Team Leader in developing methods and improvements for handling claims.
Settles claims promptly and equitably.
Obtains releases proofs of loss or compensation agreements and issues company drafts in payments for claims and expenses.
Informs claimants insureds/customers/ agents or attorney of denial of claim when applicable.
May assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements. Continues efforts to settle claims before trial.
Refers claims to subrogation as appropriate.
May participate in claim file reviews and audits with customer/insured and broker.
Administers benefits timely and appropriately. Maintains control of claims resolution process to minimize current exposure and future risks
Establishes and maintains strong customer relations i.e. agents underwriters insureds experts
Depending on line of business other duties may include:
Maintaining system logs
Investigating compensability and benefit entitlement
Reviewing and approving medical bill payments or forwarding for outside review as necessary.
Managing vocational rehabilitation
The pay range for the role is $72400 to $123100. 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 foundon 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.
Qualifications
Fouryear college degree and/or equivalent work experience or additional degrees (ex. MBA)
High level of technical claims knowledge and competence in Workers Comp claims as evidenced by demonstrated claims handling experience at ESIS (preferably 5 years claims handling experience) or within a similar organization.
Thorough knowledge of Workers Compensation products services and coverages along with a good understanding of applicable legal principles.
Knowledge of WC cost containment programs and proven account management skills a must.
Insurance Designations such as Associate in Claims (AIC) Associate in Risk Mgt (ARM) AICPCU etc.
Ability to plan organize and implement general business and people management practices as evidenced by successful completion of Management and Technical Programs completion of a business or legal college level curriculum or equivalent related practical work experience.
Demonstrated effective communication and interpersonal skills to be capable of dealing with subordinates all levels of ESIS personnel as well as attorneys producers and accounts.
Demonstrated understanding of the team building theory and how it applies to on going and planned activities.
Ability to evaluate the effectiveness of various programs and procedures and incorporate improvements. Ability to facilitate and lead group(s) of people.
Demonstrated evaluative thinking with evidence of seeking out and considering multiple sources of data to form conclusions and determine courses of action.
Evidence of strengthening personal effectiveness by demonstrating confidence credibility and commitment to established strategies and values.
Demonstrated creativity and self motivation in present position and activities through action and involvement in direct claim handling and other related functions.
Evidence of the ability to intellectually manage activities and resource allocation issues that are driven by such things as timely high quality service and longer term payback opportunities related to claims handling processing.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
