KEY OBJECTIVE:
Responsibilities include investigating claims to determine extent of injury, reserving and effective case management. Utilize medical cost containment measures to control loss dollar pay-out. Review status of claims and develop strategies to effectively manage to conclusion. Consistent delivery of superior customer service.
MAJOR DUTIES & RESPONSIBILITIES:
- Handle multiple demands & priorities, from a variety of sources, simultaneously
- Maintain ESIS Standards & Best Practices
- Adjust claims with the ability to follow company policies and procedures
- Have the ability to effectively and independently manage and maintain a workers compensation pending.
- Handle and resolve conflict effectively
- Meet goals & objectives established by ESIS and the Claims Vice President
- Escalate issues appropriately and follow through
- Be a problem solver with excellent problem resolution skills
- Meet and maintain customer service requirements and have the ability to follow ESIS processes.
- Make sound judgment decisions and have the ability to differentiate information.
- Communicate effectively both written & orally
- Respond to customers appropriately, timely & accurately
Ability to remain calm and professional during peak periods of activity.
- Handle multiple computer applications and vendor systems to manage caseloads
- Identify and determine short term and long term financial exposures and establish accurate financial reserves to meet Client, ESIS and Carrier expectations
- Effectively and accurately manage large sums of client or carrier funds
- Comply with all statutory reporting and licensing requirements for multiple jurisdictions
- Determine, calculate and issue accurate benefit payments to injured workers, medical providers and vendors in a timely fashion
Clearly and concisely document the ESIS claim system with activities, investigations and plans in a timely fashion
Qualified candidates must possess experience 5 or more years in managing workers compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation.
Experience in a third party administrator (TPA) environment is a plus.
Knowledge of Workers' Compensation laws and procedures are required.
Candidates must have the ability to work independently, while assimilating various technical subjects, as evidenced by successful completion of a college degree or equivalent practical work experience.
AIC/CPCU is preferred
Candidates must also have solid computer software skills (M/S Word, Excel).
Skills Required
- 5 or more years managing workers compensation claims investigation/adjusting, including knowledge of applicable state/local legislation
- Knowledge of Workers' Compensation laws and procedures
- Ability to work independently; college degree or equivalent practical work experience
- Solid computer software skills (Microsoft Word, Microsoft Excel)
- Experience in a third party administrator (TPA) environment
- AIC/CPCU designation
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.
