ESIS ProClaim Manager, A&H

ESIS ProClaim A&H is seeking an experienced claims professional to supervise and guide a team of Claims Representatives ensuring prompt efficient and fair claims services.

Key Objective:
Reporting to the AVP of Claims the Claims Team Leader supports all aspects of third-party claim management. This role involves assigning new claims investigating coverage examining third-party claims managing subrogation and recovery determining liability and settling claims in accordance with established best practices and client instructions. The Claims Team Leader also provides coaching guidance and development opportunities to the team.

Key Responsibilities:

• Supervise and support a team of claims professionals.
• Assign new claims and provide direction on policy coverage thorough investigation and determination of the companys obligation to the insured based on the line of business.
• Maintain a diary system to ensure each file is reviewed at least every 90 days.
• Provide ongoing coaching and constructive feedback to direct reports.
• Develop monitor and communicate performance and productivity goals.
• Review analyze and share performance results productivity data and audit/quality review outcomes.
• Ensure detailed 90-day Claim Summary Reports are prepared and provide client updates on investigations settlement opportunities claim denials reservation of rights and recommendations for claims review meetings.
• Post loss and expense reserves within authority limits and recommend reserve changes above authority to the AVP and/or VP of Claims.
• Review claim progress and status with claims leadership discussing issues opportunities and remedial actions.
• Prepare and submit reports on unusual or potentially undesirable exposures such as allegations of bad faith or unfair claim practices to claims leadership.
• Assist claims leadership in developing improvements to claims handling procedures.
• Collaborate with Partnership Leaders to deliver results attend meetings and participate in claim reviews.
• Ensure claims professionals obtain appropriate releases proofs of loss or compensation agreements and issue company payments for claims.
• Maintain accurate and complete claim files including notes reports photos and documentation.
• Adhere to all company policies and regulatory compliance requirements.

• Minimum of 5 years experience as a claims professional or in claims management with advanced technical expertise in handling Accident and Health or Travel claims.
• Possession of a P&C insurance adjuster license where required.
• Strong knowledge of insurance industry concepts claims handling practices and procedures.
• Proven experience managing complex coverage matters.
• Solid understanding of insurance fundamentals and legal principles.
• Familiarity with P&C group coverage and related services.
• Working knowledge of industry best practices and procedures.
• Demonstrated ability to work independently.
• Excellent interpersonal communication and negotiation skills with the ability to interact professionally with customers and business partners.
• Ability to make prompt well-reasoned decisions based on thorough analysis of complex issues.

ESIS a multi-line Third-Party Administrator (TPA) provides claims risk control & loss information systems toFortune 1000 clients across its North American 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.

The pay range for the role is $90000 to $130000. 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.