ESIS Senior Claims Representative, WC

Posted 3 Days Ago
Be an Early Applicant
2 Locations
In-Office
71K-104K Annually
Senior level
Insurance
The Role
Investigate, evaluate, and resolve workers' compensation claims by contacting parties, gathering statements and medical/legal information, setting reserves, preparing reports, negotiating settlements, and communicating denials. Recommend reserve changes, escalate unusual exposures, and assist the Team Leader in improving claims handling processes while ensuring timely, fair resolution in accordance with policy and best practices.
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 are dedicated to providing exceptional service and innovative solutions, and we are looking for passionate individuals to be part of our dynamic team. If you are 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!

The ESIS Senior Workers’ Compensation Claim Representative, under the direction of the Claims Team Leader, is responsible for investigating and resolving claims promptly, fairly, and in accordance with established best practices.

Major Duties & Responsibilities, but are not limited to:

  • Receives assignments and reviews claim and policy information to provide background for investigations, and may determine the extent of the policy’s obligation to the insured, depending on the line of business.
  • Contacts, interviews, and obtains statements from insured parties, claimants, witnesses, medical professionals, legal representatives, law enforcement, and other relevant individuals to gather necessary claim information.
  • Evaluates facts obtained during investigations to determine the extent of liability and the company’s obligation under the policy contract.
  • Prepares reports detailing investigations, settlements, claim denials, and evaluations of involved parties.
  • Sets reserves within authority limits and recommends reserve changes to the Team Leader.
  • Reviews the progress and status of claims with the Team Leader, discussing challenges and recommending remedial actions.
  • Prepares and submits unusual or potentially undesirable exposures to the Team Leader for review.
  • Assists the Team Leader in developing methods and improvements for handling claims.
  • Resolves claims promptly and fairly.
  • Obtains releases, proofs of loss, or compensation agreements, and issues company drafts for claim payments.
  • Communicates claim denials to claimants, insured parties, customers, or legal representatives as appropriate.
Qualifications
  • Minimum of four years of experience managing workers’ compensation claims.
  • Demonstrated ability to communicate clearly and professionally, with strong interpersonal skills for effective interactions with claimants, customers, insured parties, brokers, attorneys, and other stakeholders.
  • Proven ability to work independently and demonstrate self-motivation.
  • Solid understanding of company products, services, coverages, policy limits, and claims best practices.
  • Strong negotiation skills.
  • Experience handling workers’ compensation claims in Oregon or Hawaii is preferred.
  • This position reports to our Portland, OR, or Honolulu, HI office.

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.

ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS’ innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients’ unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry’s broadest selections of risk management solutions covering both pre- and post-loss services.

The pay range for the role is $71,000 to $104,000. The specific offer will depend on an applicant’s skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program.  Chubb offers a comprehensive benefits package, more details on which can be found on our careers website.  The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position is filled.

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

  • Minimum of four years managing workers' compensation claims.
  • Applicable resident or designated home state adjuster's license.
  • Ability to obtain/pass the adjuster licensing exam (support provided; up to 4 months allowed).
  • Clear, professional communication and strong interpersonal skills for interacting with claimants, medical professionals, attorneys, and stakeholders.
  • Proven ability to work independently and demonstrate self-motivation.
  • Solid understanding of insurance products, coverages, policy limits, and claims best practices.
  • Strong negotiation skills.
  • Experience handling workers' compensation claims in Oregon or Hawaii.
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The Company
HQ: Schweiz
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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