ESIS Senior Claims Representative, DBA
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Job Location:
Dallas, IA - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Description
Qualifications
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. As a Senior Claim Representative candidate will be responsible for more complex and intricate 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 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.
Qualifications
- Experience:Minimum of 5 years of experience handling workers compensation claims; prior experience with ESIS or similar third-party administrators is a plus.
- Knowledge & Licensing:Knowledge of Defense Based Act/Longshore claims and active adjuster license or 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 candidate will be responsible for more complex and intricate requiring an advanced skillset.
Required Experience:
Senior IC
About Company
Chubb Life has been in Egypt since 2003. Chubb Life is the international life insurance division of Chubb - the world's largest publicly traded property and casualty insurance company by market capitalization.
