ESIS Claims Representative, WC

Job Description

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, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team. If you're 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

The ESIS Workers' Compensation Claim Representative, reporting to the Claims Team Leader, is responsible for promptly and equitably investigating and resolving claims in accordance with established best practices.

Note: This is a hybrid position requiring 3 days in the office and 2 days working from home.

• Under limited supervision, receives assignments and reviews claim and policy information to gather background for investigation, determining the extent of the policy's obligation to the insured based on the line of business.
• Contacts, interviews, and obtains statements (recorded or in person) from insured individuals, claimants, witnesses, healthcare providers, attorneys, law enforcement, and others to secure necessary claim information.
• Depending on the line of business, inspects and appraises damage for property losses or arranges for such appraisals.
• Evaluates facts gathered from investigations to determine the extent of liability of the insured, if applicable, and the company's obligations to the insured under the policy contract.
• Prepares reports on investigations, settlements, denials of claims, and evaluations of involved parties.
• Sets reserves within authority limits and recommends reserve adjustments to the Team Leader.
• Reviews the progress and status of claims with the Team Leader, discussing challenges and suggesting potential solutions.
• Prepares and submits to the Team Leader any unusual or potentially undesirable exposures.
• Collaborates with the Team Leader to develop methods and improvements for handling claims.
• Settles claims promptly and equitably.
• Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
• Notifies claimants, insured individuals/customers, or attorneys of claim denials when applicable.

Qualifications

• Experience handling workers' compensation claims, demonstrated by career progression within the company or a similar organization.
• Ability to work independently with minimal direction from a Team Leader.
• Strong technical knowledge of claims handling processes and terminology.
• Excellent negotiation skills.
• Effective communication and interpersonal skills for positively engaging with claimants, customers, insured individuals, brokers, attorneys, and others regarding losses.
• In-depth knowledge of the company's products, services, coverages, and policy limits, along with a solid understanding of claims best practices.
• Comprehensive understanding of applicable state and local laws related to the line of business handled.
• Exceptional customer service skills.
• California certification required.

An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's 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 $58,900 to $100,100. The specific offer will depend on an applicant's 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 found on 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 multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides 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.

About Us

Chubb 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.

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