ESIS Claims Representative, WC

Chubb Corporation; Tampa (FL); On-site; USD 42,000 - 66,000; Full time

Job summary

ESIS is seeking entry-level claims staff to start under direct supervision, training to become a claims representative. You will gradually handle a caseload while learning across the claims process.

You will investigate, evaluate, and manage workers' compensation claims, communicate with injured workers and providers, and document all activities in our system. This role offers growth within a supportive team at ESIS in Florida.

Qualifications

• Training program to become a claims representative, with classroom and hands-on learning.
• Gains exposure to all facets of professional claims roles.
• Attention to laws, regulations, and company policies.

Responsibilities

• Investigate, evaluate, and manage workers' compensation claims from start to finish.
• Serve as primary contact for injured workers, employers, medical providers.
• Conduct investigations by gathering statements and reviewing records.
• Make timely decisions on claim acceptance, denial, or settlement.
• Maintain organized claim files and document activities in the system.
• Monitor claim costs and reserves, ensuring accuracy.
• Ensure adherence to state workers' comp laws and reporting requirements.
• Provide exceptional service, addressing inquiries and updates on status.
• Collaborate with legal, medical, and risk teams to optimize outcomes.

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.