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C
Chubb
ESIS Claims Representative, WC
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Based on Pennsylvania data
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What they do
A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.
$57,306 / year median in Pennsylvania
+3% projected growth
Job Description
Sign in with Google Use your Google account to sign into efinancialcareers. Sign in with Google Sign in with Google. Opens in new tab ESIS Claims Representative, WC Chubb Philadelphia, United States Apply now Save Posted 18 hours ago Permanent $62k
- $81k ESIS Claims Representative, WC Chubb Philadelphia, United States Apply now Save ESIS Claims Representative, WC Job Description Are you looking to grow your career in workers' compensation and claims support?
Claims Management:
Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies.Communication:
Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.Investigation:
Conduct thorough investigations of claims, 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 the facts of the case and applicable laws.Documentation:
Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system.Cost Control:
Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while 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.Qualifications Preferred Qualifications:
A minimum of 2 years' experience in handling workers' compensation claims, with prior experience at ESIS or similar third-party administrators being advantageous, and/or Bachelor's degree or equivalent experience.Industry Knowledge:
Strong familiarity with workers' compensation laws, medical terminology, and best practices in claims handling is preferred.Technical Skills:
Demonstrated proficiency in claims management systems and the Microsoft Office Suite.Communication Skills:
Excellent written and verbal communication skills, enabling effective interactions with external investigative sources and insureds over the phone.Team Collaboration:
Proven ability to contribute effectively within a team environment, providing and receiving constructive feedback while identifying growth opportunities for both self and colleagues.Analytical Skills:
Strong analytical and problem-solving abilities to navigate complex scenarios efficiently.Organizational Skills:
Capable of managing multiple priorities and meeting deadlines in a fast-paced work environment.Customer Focus:
Strong commitment to customer service, with a proactive approach to addressing and supporting customer needs.Judgment and Decision-Making:
Confidence in personal judgment, with the ability to support and defend decisions made. Commitment toExcellence:
Dedicated to maintaining high standards of behavior and performance.Adaptability:
Flexible in adapting approaches and behaviors to fit specific situations effectively.Positive Representation:
Strong focus on building and maintaining a positive image for Chubb and ESIS.Skills:
Strong analytical and problem-solving abilities. Excellent verbal and written communication skills. Proficiency in claims management systems and Microsoft Office Suite. Ability to manage multiple priorities and meet deadlines in a fast-paced environment.Knowledge:
Familiarity with workers' compensation laws, medical terminology, and claim handling best practices. 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. 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.
ID 300003433306104
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