ESIS Claim Representative, WC

Are you looking to grow your career in workers compensation and claims support 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.

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

Duties and Responsibilities

• Claims Management:Investigate evaluate and manage workers compensation claims from inception to resolution ensuring compliance with applicable laws regulations and company policies.
• Communication:Act as the primary point of contact for injured workers employers medical providers and other stakeholders delivering clear and professional communication throughout the claims process.
• Investigation:Conduct thorough investigations including gathering statements reviewing medical records and analyzing accident reports to determine compensability and liability.
• Decision-Making:Make timely and accurate decisions regarding claim acceptance denial or settlement based on case facts and applicable laws.
• Documentation:Maintain detailed and organized claim files documenting all activities communications and decisions within the claims management system.
• Cost Control:Monitor and manage claim costs including medical expenses indemnity payments and legal fees ensuring appropriate reserves are established and maintained.
• Compliance:Ensure adherence to state-specific workers compensation laws regulations and reporting requirements.
• Customer Service:Provide exceptional service to clients by addressing inquiries resolving issues and delivering timely updates on claim status.
• Collaboration:Work closely with internal teams including legal medical and risk management professionals to achieve optimal claim outcomes.

• Experience:Minimum of 2-3 years of experience handling workers compensation claims; prior experience with ESIS or similar third-party administrators is a plus.
• Knowledge & Licensing:Knowledge of Nevada California or Arizona Workers Compensation and active adjuster license or ability to obtain licensure within a specified timeframe.
• Skills:
  • Strong analytical and problem-solving skills.
  • Excellent verbal and written communication abilities.
  • Proficiency with claims management systems and Microsoft Office Suite.
  • Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
  • Familiarity with workers compensation laws medical terminology and claim handling best practices.

An applicable resident or designated home state adjusters license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESISs employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

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 industrys broadest selections of risk management solutions covering both pre- and post-loss services.

The pay range for the role is $62700 to $83000. The specific offer will depend on an applicants 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.