ESIS Claims Specialist, WC

Chubb•Chatsworth, CA

1d•Hybrid

About The Position

ESIS is seeking a skilled Claims Specialist to join their team. This role is vital in investigating and managing workers' compensation claims promptly and equitably, adhering to established best practices. The position is hybrid, requiring three days per week in the Chatsworth office, with potential for fully remote work for experienced individuals located more than an hour from an office. ESIS, a Chubb company, offers claim and risk management services with a focus on innovative program design and client-specific risk management needs. With over 70 years of experience and global offerings, ESIS provides a broad selection of risk management solutions.

Requirements

5 or more years’ experience handling workers' compensation claims as evidenced by career progression within the company or similar organization.
Ability to work independently with limited direction from a Team Leader.
Authoritative technical knowledge of claims handling and claims terminologies.
Superior negotiation skills.
Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses.
Strong knowledge of the company’s products, services, coverage’s and policy limits, along with a solid understanding of claims best practices.
Commanding knowledge of applicable state and local laws related to line of business handled.
Superior customer service skills
California Certified 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.

Responsibilities

Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business.
Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
Depending on line of business may inspect and appraise damage for property losses or arranges for such appraisal.
Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company’s obligation to the insured under the policy contract.
Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
Sets reserves within authority limits and recommends reserve changes to Team Leader.
Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.
Prepares and submits to Team Leader unusual or possible undesirable exposures.
Assists Team Leader in developing methods and improvements for handling claims.
Settles claims promptly and equitably.
Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
Informs claimants, insureds/customers or attorney of denial of claim when applicable.