ESIS Claims Representative, WC

Posted 2 Days Ago
Be an Early Applicant
2 Locations
In-Office
Entry level
Insurance
The Role
Train under supervision to handle workers' compensation claims from intake through resolution. Investigate incidents, evaluate medical records, communicate with stakeholders, document files, manage costs and reserves, ensure regulatory compliance, and collaborate with legal, medical, and risk teams to achieve timely, compliant claim outcomes.
Summary Generated by Built In

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.
Qualifications
  • 2 years' experience in handling Florida workers compensation claims, with prior experience at ESIS or similar third-party administrators being advantageous, and/or Bachelor’s degree or equivalent experience.
  • Industry Knowledge: Strong familiarity with workers' compensation laws, medical terminology, and best practices in claims handling is preferred.
  • Technical Skills: Demonstrated proficiency in claims management systems and the Microsoft Office Suite.
  • Communication Skills: Excellent written and verbal communication skills, enabling effective interactions with external investigative sources and insureds over the phone.
  • Team Collaboration: Proven ability to contribute effectively within a team environment, providing and receiving constructive feedback while identifying growth opportunities for both self and colleagues.
  • Analytical Skills: Strong analytical and problem-solving abilities to navigate complex scenarios efficiently.
  • Organizational Skills: Capable of managing multiple priorities and meeting deadlines in a fast-paced work environment.
  • Customer Focus: Strong commitment to customer service, with a proactive approach to addressing and supporting customer needs.
  • Judgment and Decision-Making: Confidence in personal judgment, with the ability to support and defend decisions made.
  • Commitment to Excellence: Dedicated to maintaining high standards of behavior and performance.
  • Adaptability: Flexible in adapting approaches and behaviors to fit specific situations effectively.
  • Positive Representation: Strong focus on building and maintaining a positive image for Chubb and ESIS.

Skills:

  • Strong analytical and problem-solving abilities.
    • Excellent verbal and written communication skills.
    • Proficiency in claims management systems and Microsoft Office Suite.
    • Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
  • Knowledge: Familiarity with workers' compensation laws, medical terminology, and claim handling best practices.
About Us
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.

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.

Skills Required

  • Proficiency in claims management systems
  • Proficiency in Microsoft Office Suite
  • Excellent written and verbal communication skills
  • Ability to manage multiple priorities and meet deadlines
  • Strong analytical and problem-solving abilities
  • Familiarity with workers' compensation laws, medical terminology, and claims handling best practices
  • 2 years' experience handling Florida workers' compensation claims (preferred)
  • Prior experience at ESIS or similar third-party administrators (advantageous)
  • Bachelor's degree or equivalent experience (preferred)
  • Team collaboration and customer service focus
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The Company
HQ: Zürich
27,791 Employees

What We Do

Chubb is the world’s largest publicly traded property and casualty insurance company. With operations in 54 countries and territories, 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. As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. The company is also defined by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength and local operations globally. Parent company Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains executive offices in Zurich, New York, London, Paris and other locations, and employs 31,000 people worldwide. Additional information can be found at: chubb.com.

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