ESIS Senior Claims Representative, WC

ESIS Senior Claims Representative Workers Compensation (WC) Tampa FL

Description

Join ESIS as a Senior Claims Representative in Tampa FL specializing in Workers Compensation. This role offers a flexible hybrid work schedulework 3 days in the office and 2 days remotely each weekproviding the balance you need to excel professionally and personally.

Key Responsibilities:

Claims Management: Investigate evaluate and manage workers compensation claims from inception to resolution ensuring compliance with applicable laws regulations and company policies. Handle complex and intricate cases requiring an advanced skillset.
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 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.

Experience: Minimum of 5 years handling workers compensation claims; prior experience with ESIS or similar third-party administrators is a plus.
Knowledge & Licensing: Knowledge of Florida Workers Compensation and an active adjuster license or the ability to obtain licensure within a specified timeframe.
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. As a Senior Claim Representative you will handle more complex and intricate cases requiring advanced skills.

Ready to advance your career with ESIS
Apply today and be part of a team dedicated to excellence in claims management with the flexibility of a hybrid work environment.