Combined Insurance ESIS Claim Representative, Workers' Compensation in United States
Chubb is the world’s largest publicly traded property and casualty insurer. 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.**
ESIS, Inc. (ESIS)provides sophisticated risk management services designed to reduce claims frequency and loss costs. ESIS, the Risk Management Services Company of ACE USA, provides claims, risk control & loss information systems to Fortune 1000 accounts. ESIS employs more than 1,500 professionals in nine regional centers and 15 major claims offices, as well as local representatives in select jurisdictions. We take our fiduciary responsibilities seriously and are proud to manage over $2.5 billion of customer losses and over 320,000 new claims annually. We specialize in large accounts which have multi-state operations. For information regarding ESIS please visitwww.esis.com.**
SUMMARY: ESIS is seeking an experienced workers compensation claims representative for the Wilmington, DE office. The person in this role will handle and maintain all workers’ compensation claims and file reviews under general supervision of a supervisor and as part of the ESIS team.
KEY OBJECTIVE: Responsibilities include investigating claims to determine extent of injury, reserving and effective case management. Utilize medical cost containment measures to control loss dollar pay-out. Review status of claims and develop strategies to effectively manage to conclusion. Consistent delivery of superior customer service. Qualified candidates must possess experience in managing workers compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation. Experience in a third party administrator (TPA) environment is a plus. Knowledge of DE, NJ, PA, NY Workers' Compensation laws and procedures are required. Candidates must have the ability to work independently, while assimilating various technical subjects, as evidenced by successful completion of a college degree or equivalent practical work experience. AIC/CPCU is preferred, and candidates must also have solid computer software skills (M/S Word, Excel).
*MAJOR DUTIES & RESPONSIBILITIES: * - Handle multiple demands & priorities, from a variety of sources, simultaneously - Maintain ESIS Standards & Best Practices - Adjust claims with the ability to follow company policies and procedures - Have the ability to effectively and independently manage and maintain a workers compensation pending of no less than 165. - Handle and resolve conflict effectively - Meet goals & objectives established by ESIS and the Claims Vice President - Escalate issues appropriately and follow through - Be a problem solver with excellent problem resolution skills - Meet and maintain customer service requirements and have the ability to follow ESIS processes. - Make sound judgment decisions and have the ability to differentiate information. - Communicate effectively both written & orally - Respond to customers appropriately, timely & accurately - Ability to remain calm and professional during peak periods of activity. - Handle multiple computer applications and vendor systems to manage caseloads - Identify and determine short term and long term financial exposures and establish accurate financial reserves to meet Client, ESIS and Carrier expectations - Effectively and accurately manage large sums of client or carrier funds - Comply with all statutory reporting and licensing requirements for multiple jurisdictions - Determine, calculate and issue accurate benefit payments to injured workers, medical providers and vendors in a timely fashion - Clearly and concisely document the ESIS claim system with activities, investigations and plans in a timely fashion
Qualified candidates must possess experience in managing workers compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation.
Experience in a third party administrator (TPA) environment is a plus.
Knowledge of DE, NJ, PA, NY Workers' Compensation laws and procedures are required.
Candidates must have the ability to work independently, while assimilating various technical subjects, as evidenced by successful completion of a college degree or equivalent practical work experience.
Candidates must also have solid computer software skills (M/S Word, Excel).
Chubb offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, a generous retirement savings plan, disability coverage, stock purchase plan, flexible spending accounts, tuition reimbursement, and business casual dress. 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, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.
Title: ESIS Claim Representative, Workers' Compensation
Requisition ID: 322624