ESIS Claims Representative, WC

About the role

Join ESIS, a leader in risk management and insurance services, where you can help support effective claims handling and contribute to positive outcomes for employees and clients. As a Senior Workers’ Compensation Claim Representative, you will investigate and resolve claims promptly, fairly, and in accordance with established best practices under the direction of the Claims Team Leader.

Responsibilities

• Receive assignments and review claim and policy information to support the investigation and determine the extent of the policy’s obligation to the insured, depending on the line of business.
• Contact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, police officers, and others to gather necessary claim information.
• Evaluate facts obtained through investigation to determine the extent of liability and the company’s obligation to the insured under the policy contract.
• Prepare reports related to investigations, settlements, claim denials, and evaluations of involved parties.
• Set reserves within authority limits and recommend reserve changes to the Team Leader.
• Review claim progress and status with the Team Leader and discuss issues and recommended corrective actions.
• Submit unusual or potentially adverse exposures to the Team Leader for review.
• Assist the Team Leader in developing methods and process improvements for claims handling.
• Settle claims promptly and fairly, obtaining releases, proofs of loss, or compensation agreements and issuing company drafts for claim payments.
• Inform claimants, insureds/customers, or attorneys of claim denials when applicable.

Requirements

• 2–4 years of experience handling workers’ compensation claims.
• Strong communication and interpersonal skills, with the ability to interact professionally and effectively with claimants, customers, insureds, brokers, attorneys, and other stakeholders.
• Ability to work independently, manage priorities, and take initiative.
• Knowledge of company products, services, coverages, policy limits, and claims best practices.
• Strong negotiation skills.
• Experience handling workers’ compensation claims in California is preferred.
• 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.

About Us

ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. With more than 70 years of experience, ESIS offers one of the industry’s broadest selections of risk management solutions covering both pre- and post-loss services in the U.S. and globally. Chubb is a world leader in insurance, operating in 54 countries and providing commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance.

Pay

The pay range for this role is $62,700 to $81,300. 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.

Benefits

Chubb offers a comprehensive benefits package. More details can be found on the company’s careers website.