ESIS Claims Specialist, WC

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.

About the role

Under the direction of the Claims Team Leader, the Workers’ Compensation Claim Specialist investigates, evaluates, and resolves claims in a timely, fair, and consistent manner, in alignment with established best practices.

Responsibilities

• Work under limited supervision to receive assignments and review claim and policy information to support investigation and coverage analysis.
• Contact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to gather necessary claim information.
• Evaluate facts gathered through investigation to determine liability, if any, and the company’s obligations under the policy contract.
• Prepare reports related to investigations, settlements, claim denials, and case evaluations.
• Establish 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 next steps.
• Prepare and submit information regarding unusual or potentially significant exposures to the Team Leader.
• Support the Team Leader in identifying process improvements and enhancing claims handling practices.
• Resolve claims in a timely and equitable manner.
• Obtain releases, proofs of loss, or compensation agreements and issue payments for claims as appropriate.
• Communicate claim denials to claimants, insureds, customers, or attorneys when applicable.

Requirements

• 4 or more years of experience handling workers’ compensation claims
• Strong written and verbal communication skills, with the ability to interact professionally with claimants, customers, insureds, brokers, attorneys, and other stakeholders
• Ability to work independently and manage priorities effectively
• Knowledge of company products, services, coverages, policy limits, and claims best practices
• Strong negotiation skills
• Experience handling workers’ compensation claims in California or Hawaii 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 ESIS

ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS’ innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients’ unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry’s broadest selections of risk management solutions covering both pre- and post-loss services.

Pay

The pay range for the role is $71,000 to $114,000. 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 on which can be found on our careers website.