Senior Claim Examiner-Workers Compensation

JOB DESCRIPTIONChubb is currently seeking a Workers' Compensation Lost Time Senior Claim Examiner for our Northeast, New York, and New Jersey Region. The successful applicant will be handling claims from Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, and New Jersey. The position will report to a Claim Manager and reside in our New Haven, Connecticut, office.Duties & Responsibilities:Requires minimal oversight to independently handle all aspects of workers' compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the processReviews claim and policy information to provide background for investigationConducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providersEvaluates the facts gathered through the investigation to determine compensability of the claimInforms insureds, claimants and attorneys of claim denials when applicablePrepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.Timely administration of statutory medical and indemnity benefits throughout the life of the claimSets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to the Leadership Team throughout the life of the claimReviews the claim status at regular intervals and makes recommendations to the Leadership Team to discuss problems and remedial actions to resolve themPrepares and submits to Leadership Team unusual or possible undesirable exposures when encounteredWorks with attorneys to manage hearings and litigationControls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiativesComplies with customer service requests including Special Claims Handling procedures, file status notes, and claim reviewsFiles workers' compensation forms and electronic data with states to ensure compliance with statutory regulationsRefers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximizedWorks with in-house Technical Assistants, Special Investigators, NurseConsultants, Telephonic Case Managers as well as the Leadership Team to exceed customer's expectations for exceptional claims handling serviceTechnical Skills & Competencies:Understands day-to-day responsibilities of a Lost Time Claim Examiner in managing all aspects of workers' compensation claimsWorks with a high degree of autonomy and showcases venue expertiseServes as a mentor and informal leader to staff with less seniorityUtilizes influence management skills to drive results, consistency amongst peers and as motivationProvides project managementServes as a subject matter expertRequires knowledge of workers' compensation statutes, regulations, and complianceAbility to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issuesExceptional customer service and focusAbility to openly collaborate with leadership and peers to accomplish goalsDemonstrates a commitment to a career in claimsExceptional time management and multi-tasking capabilities with consistent follow through to meet deadlinesUse analytical skills to find mutually beneficial solutions to claim and customer issuesAbility to prepare and make exceptional presentations to internal and external customersConscientious about the quality and professionalism of work product andrelationships with co-workers and clientsWilling to take ownership and tackle obstacles to meet Chubb's qualitystandards for service, investigation, reserving, inventory management, teamwork, and diversity appreciationSuperior verbal and written communication skillsExperience, Education & Requirements:4+ years of direct handling claims for workers' compensation lost time claimsExperience working in a customer focused, fast-paced, fluid environmentExperience utilizing strong communication and telephonic skillsPrior experience demonstrating a high level of organization, follow-up and accountabilityAIC, RMA, or CPCU completed coursework or designation(s) is a plus but not requiredExperience with litigation managementExperience with subrogation investigationsExperience with fraud investigationsExperience with medical case managementKnowledge of medical terminologyConduct reserve analyses to ensure adequacy and demonstrate financial acumemProficiency with Microsoft Office ProductsIf you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.ABOUT USChubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment. #J-18808-Ljbffr