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About the Role
Under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably, and within established best practices guidelines.
Responsibilities
- Receive new assignments.
- Review claim and policy information to provide background for investigation and determine policy obligations.
- Contact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, and police officers.
- Arrange for surveys and experts.
- Evaluate investigation findings to determine liability and company obligations.
- Prepare reports on investigation, settlements, and claim denials.
- Set reserves within authority limits and recommend reserve changes.
- Review claim progress and status with Team Leader, discussing problems and solutions.
- Manage litigation files in a timely and appropriate manner.
- Assist Team Leader in developing claims handling methods and improvements.
- Settle claims promptly and equitably.
- Obtain releases, proofs of loss, or compensation agreements and issue payment drafts.
- Inform claimants, insureds, customers, agents, or attorneys of claim denials.
- Assist Team Leader and company attorneys in preparing cases for trial.
- Refer claims to subrogation as appropriate.
- Participate in claim file reviews and audits with customers/insureds and brokers.
- Administer benefits timely and appropriately.
- Maintain control of the claims resolution process to minimize exposure and risks.
- Establish and maintain strong customer relations.
- Maintain system logs.
- Investigate compensability and benefit entitlement.
- Review and approve medical bill payments or forward for outside review.
- Manage vocational rehabilitation.
Requirements
- Four-year college degree and/or equivalent work experience or additional degrees (e.g., MBA).
- High level of technical claims knowledge and competence in Workers' Comp claims.
- Demonstrated claims handling experience at ESIS (preferably 5 years) or a similar organization.
- Thorough knowledge of Workers' Compensation products, services, and coverages.
- Good understanding of applicable legal principles.
- Knowledge of WC cost containment programs.
- Proven account management skills.
- Insurance Designations such as Associate in Claims (AIC), Associate in Risk Management (ARM), AICPCU, etc.
- Ability to plan, organize, and implement general business and people management practices.
- Demonstrated effective communication and interpersonal skills.
- Demonstrated understanding of team building theory.
- Ability to evaluate program and procedure effectiveness and incorporate improvements.
- Ability to facilitate and lead groups.
- Demonstrated evaluative thinking with evidence of seeking and considering multiple data sources.
- Evidence of strengthening personal effectiveness by demonstrating confidence, credibility, and commitment.
- Demonstrated creativity and self-motivation.
- Evidence of the ability to intellectually manage activities and resource allocation.
Skills
- Workers' Comp claims handling
- Account management
- Communication skills
- Interpersonal skills
- Team building
- Evaluative thinking
- Creativity
- Self-motivation
- Resource allocation
Location
- ESIS
Work Type
- Full-time
Experience Level
- 5 years claims handling experience (preferred)
Education Level
- Four-year college degree
- MBA (preferred)
- Associate in Claims (AIC)
- Associate in Risk Management (ARM)
- AICPCU
Salary/Compensations
- $71,000 to $104,000
- Discretionary annual incentive program
Benefits
- Comprehensive benefits package
About the Company
- Chubb is a world leader in insurance with operations in 54 countries.
- Provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance.
- Distinguished by extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise, and local operations globally.
Equal Opportunity
- Committed to equal employment opportunity and compliance with all laws and regulations.
- Provides employment, training, compensation, promotion, and other conditions 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 for hiring, assignment, promotion, compensation, development, and retention.
- Prohibits unlawful discrimination, harassment, and retaliation.