ESIS Claims Representative, WC

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 were dedicated to providing exceptional service and innovative solutions and were looking for passionate individuals to be part of our dynamic team. If youre 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!

Under direct supervision initially performs customer service and/or claims functions while training to become a claims representative. Gains exposure to all facets of a professional claims representative position through classroom and hands on learning. Will be assigned a caseload as training progresses.

Duties may include but are not limited to:

• Claims Management:Investigate evaluate and manage workers compensation claims from inception to resolution ensuring compliance with applicable laws regulations and company policies.
• Communication:Serve as the primary point of contact for injured workers employers medical providers and other stakeholders providing clear and professional communication throughout the claims process.
• Investigation:Conduct thorough investigations of claims including gathering statements reviewing medical records and analyzing accident reports to determine compensability and liability.
• Decision-Making:Make timely and accurate decisions regarding claim acceptance denial or settlement based on the facts of the case and applicable laws.
• Documentation:Maintain detailed and organized claim files documenting all activities communications and decisions in the claims management system.
• Cost Control:Monitor and manage claim costs including medical expenses indemnity payments and legal fees while ensuring appropriate reserves are established and maintained.
• Compliance:Ensure adherence to state-specific workers compensation laws regulations and reporting requirements.
• Customer Service:Provide exceptional service to clients by addressing inquiries resolving issues and delivering timely updates on claim status.
• Collaboration:Work closely with internal teams including legal medical and risk management professionals to achieve optimal claim outcomes.

• Preferred Qualifications: A minimum of 2 years experience in handling workers compensation claims in AZ CA or NV is preferred with prior experience at ESIS or similar third-party administrators being advantageous and/or Bachelors degree or equivalent experience.
• Industry Knowledge: Strong familiarity with workers compensation laws medical terminology and best practices in claims handling is preferred.
• Technical Skills: Demonstrated proficiency in claims management systems and the Microsoft Office Suite.
• Communication Skills: Excellent written and verbal communication skills enabling effective interactions with external investigative sources and insureds over the phone.
• Team Collaboration: Proven ability to contribute effectively within a team environment providing and receiving constructive feedback while identifying growth opportunities for both self and colleagues.
• Analytical Skills: Strong analytical and problem-solving abilities to navigate complex scenarios efficiently.
• Organizational Skills: Capable of managing multiple priorities and meeting deadlines in a fast-paced work environment.
• Customer Focus: Strong commitment to customer service with a proactive approach to addressing and supporting customer needs.
• Judgment and Decision-Making: Confidence in personal judgment with the ability to support and defend decisions made.
• Commitment to Excellence: Dedicated to maintaining high standards of behavior and performance.
• Adaptability: Flexible in adapting approaches and behaviors to fit specific situations effectively.
• Positive Representation: Strong focus on building and maintaining a positive image for Chubb and ESIS.
• Skills:
  • Strong analytical and problem-solving abilities.
  • Excellent verbal and written communication skills.
  • Proficiency in claims management systems and Microsoft Office Suite.
  • Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Knowledge:Familiarity with workers compensation laws medical terminology and claim handling best practices.

An applicable resident or designated home state adjusters license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESISs 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 $60700 to $93000. 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.

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 industrys broadest selections of risk management solutions covering both pre- and post-loss services.