ESIS Claims Representative, WC

Chubb•Dallas, TX

About The Position

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.

Requirements

5 or more years in managing workers compensation claims investigation/ adjusting
Knowledge of applicable state/local legislation
Knowledge of Workers' Compensation laws and procedures
Ability to work independently, while assimilating various technical subjects
Solid computer software skills (M/S Word, Excel)

Nice To Haves

Experience in a third party administrator (TPA) environment
Successful completion of a college degree or equivalent practical work experience
AIC/CPCU

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