ESIS Claims Representative, WC

Chubb Ltd.; Dallas (TX); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Chubb Ltd. is seeking a claims professional to investigate, reserve, and manage workers' compensation cases. You will work to control loss dollars, review claims status, and develop strategies to bring cases to conclusion while delivering superior customer service.

The role requires handling multiple priorities, adhering to ESIS standards, and maintaining accurate documentation. Strong communication and problem-solving skills are essential for success.

Qualifications

• Experience investigating workers' compensation claims.
• Proven ability to manage caseloads with accuracy and timeliness.
• Strong communication and documentation skills.

Responsibilities

• Handle multiple demands and priorities from diverse sources.
• Adjust claims following company policies and procedures.
• Manage workers' compensation pending files effectively.
• Resolve conflicts and communicate results clearly.
• Meet ESIS and Claims VP goals and objectives.
• Document activities, investigations and plans in the ESIS system.

Skills

Claims investigation

Customer service

Multi-tasking

Policy compliance

Problem solving

Communication skills

Tools

ESIS systems

Job description

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.

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.
• 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