ESIS Claims Representative, WC

Chubb Ltd.; Tampa (FL); On-site; USD 42,000 - 58,000; Full time

Job summary

ESIS is seeking individuals to join our workers' compensation team in Tampa. Under supervision, you will train to become a claims representative and handle a caseload as you progress. The role emphasizes learning the claims process, customer communication, and collaboration with legal and risk teams.

You will gain exposure to investigations, documentation, and cost management while delivering excellent service to injured workers and employers across our network.

Qualifications

• Training to become a claims representative under direct supervision.
• Gains exposure to all facets of a professional claims representative position through classroom and hands-on learning.

Responsibilities

• Investigate, evaluate, and manage workers' compensation claims from inception to resolution.
• Serve as the primary contact for injured workers, employers, and medical providers.
• Conduct thorough investigations including statements review and accident analysis.
• Make timely decisions regarding claim acceptance, denial, or settlement.
• Maintain detailed claim files and document activities in the system.
• Monitor and manage costs while ensuring appropriate reserves.
• Ensure adherence to state workers' compensation laws and reporting requirements.
• Provide exceptional service and timely updates to clients.
• Collaborate with legal, medical, and risk management teams for optimal outcomes.

Skills

Claims processing

Attention to detail

Communication

Customer service

Tools

Claims management software

Job description

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we’re dedicated to providing exceptional service and innovative solutions, and we’re looking for passionate individuals to be part of our dynamic team. If you’re eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

Under direct supervision initially, customer service and/or claims functions perform while training to become a claims representative. Gains exposure to all facets of a professional claims representative position through classroom and hands on learning. Will be assigned a caseload as training progresses.

Duties may include but are not limited to:

• 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.