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About the Role

The ESIS Senior Claims Representative, WC is responsible for managing workers’ compensation claims with a high level of technical expertise, sound judgment, and strong customer service. This role partners with internal and external stakeholders to investigate claims, evaluate liability and exposure, and drive timely, equitable resolutions that support positive outcomes for all parties involved.

Responsibilities

Receive and manage new claim assignments.
Review claim and policy information to support investigation and determine the extent of the company’s obligation under the policy.
Contact and interview insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to gather necessary claim information.
Arrange surveys and engage experts when appropriate.
Evaluate facts gathered through investigation to determine liability and the company’s obligation under the policy contract.
Prepare reports related to investigations, settlements, claim denials, and evaluations of involved parties.
Establish reserves within authority limits and recommend reserve changes to the Team Leader.
Review claim progress and status with the Team Leader and discuss challenges and recommended next steps.
Manage litigation files in a timely and appropriate manner.
Support the Team Leader in identifying process improvements and enhanced claim handling methods.
Resolve claims promptly and equitably.
Obtain releases, proofs of loss, or compensation agreements and issue company drafts for claim and expense payments.
Communicate claim denials to claimants, insureds, customers, agents, or attorneys, as appropriate.
Support the Team Leader and company attorneys in trial preparation by coordinating witness attendance and obtaining statements, while continuing settlement efforts when possible.
Refer claims to subrogation as appropriate.
Participate in claim file reviews and audits with customers, insureds, and brokers.
Administer benefits in a timely and appropriate manner while maintaining control of the claim resolution process to help minimize current exposure and future risk.
Build and maintain strong working relationships with agents, underwriters, insureds, experts, and other partners.
Maintain accurate system logs and documentation.

Requirements

Four-year college degree and/or equivalent work experience.
High level of technical claims knowledge and competence in workers’ compensation claims, demonstrated through claims handling experience at ESIS or a similar organization, preferably 5+ years.
Strong knowledge of workers’ compensation products, services, coverages, and applicable legal principles.
Knowledge of WC cost containment programs and strong account management skills.
Ability to plan, organize, and implement business and people management practices, supported by relevant education or equivalent practical experience.
Strong communication and interpersonal skills with the ability to work effectively across all levels of the organization and with external partners.
Understanding of team-building principles and how they support ongoing and planned activities.
Ability to evaluate programs and procedures and recommend improvements.
Ability to facilitate and lead groups effectively.
Strong evaluative thinking skills, including the ability to gather and assess multiple sources of information before making decisions.
Demonstrated professionalism, credibility, and commitment to organizational strategies and values.
Creativity and self-motivation, with evidence of initiative in claim handling and related responsibilities.
Ability to manage priorities and resources effectively in support of timely, high-quality service and long-term claims outcomes.
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.

Skills

Technical expertise
Sound judgment
Strong customer service
Workers’ compensation claims management
Claims handling
Account management
Communication skills
Interpersonal skills
Team-building
Evaluative thinking
Professionalism
Credibility
Creativity
Self-motivation
Priority management
Resource management

Location

Cheektowaga, NY

Work Type

Full-time

Experience Level

5+ years

Education Level

Bachelor's degree
Equivalent work experience
MBA (preferred)
AIC (preferred)
ARM (preferred)
AICPCU (preferred)

Salary/Compensations

$71,000 to $104,000

Benefits

Discretionary annual incentive program
Comprehensive benefits package

About the Company

Chubb is a world leader in insurance. 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.

Equal Opportunity

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, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.