ESIS Senior Claims Representative, WC

7 days ago

Chatsworth, United States Chubb Full time
JOB DESCRIPTION

The ESIS Senior Work Comp Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines.

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

Duties include but are not limited to:
  • Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.
  • Complete claim investigation via phone and email to injured workers, medical providers and employers.
  • Handles jurisdictional notices, payment of benefits, scheduling medical appointments, completion and filing of necessary forms
  • Review medical reports and information to determine compensability of claims.
  • Work with Special Investigation Unit when necessary
  • Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
  • Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
  • Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
  • Informs claimants, insureds/customers or attorney of denial of claim when applicable.
  • Assists with new losses, verifies accuracy of information
  • Direct attorney representation to strategize case resolution
  • Handles other administrative duties for the team as assigned
QUALIFICATIONS
  • 5

    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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