ESIS Claims Representative, WC

Chubb • Tigard, OR

2d • $62,700 - $81,300

About The Position

Under the direction of the Claims Team Leader, the Senior Workers’ Compensation Claim Representative investigates and resolves claims promptly, fairly, and in accordance with established best practices. ESIS is a leader in risk management and insurance services, where you can help support effective claims handling and contribute to positive outcomes for employees and clients.

Requirements

• Workers' compensation claims handling experience
• Ability to investigate and resolve claims promptly and fairly
• Knowledge of established best practices in claims handling
• Ability to interview and obtain statements from various parties
• Skill in evaluating facts to determine liability and policy obligations
• Experience in preparing claim-related reports
• Ability to set reserves within authority limits
• Understanding of claim progress and status review
• Ability to identify and report unusual or adverse exposures
• Skill in assisting with process improvements for claims handling
• Ability to settle claims promptly and fairly
• Experience obtaining releases, proofs of loss, or compensation agreements
• Ability to inform claimants, insureds/customers, or attorneys of claim denials

Nice To Haves

• Experience supporting effective claims handling
• Contribution to positive outcomes for employees and clients

Responsibilities

• Under limited supervision, receives assignments and reviews claim and policy information to support the investigation and determine the extent of the policy’s obligation to the insured, depending on the line of business.
• Contacts, interviews, and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, and others to gather necessary claim information.
• Evaluates facts obtained through investigation to determine the extent of liability, if any, and the company’s obligation to the insured under the policy contract.
• Prepares reports related to investigations, settlements, claim denials, and evaluations of involved parties.
• Sets reserves within authority limits and recommends reserve changes to the Team Leader.
• Reviews claim progress and status with the Team Leader and discusses issues and recommended corrective actions.
• Submits unusual or potentially adverse exposures to the Team Leader for review.
• Assists the Team Leader in developing methods and process improvements for claims handling.
• Settles claims promptly and fairly.
• Obtains releases, proofs of loss, or compensation agreements and issues company drafts for claim payments.
• Informs claimants, insureds/customers, or attorneys of claim denials when applicable.

Benefits

• Equal employment opportunity
• Compliance with all laws and regulations pertaining to employment
• 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 as the only basis for hiring, assignment, promotion, compensation, development, and retention.
• Prohibition of unlawful discrimination, harassment, and retaliation.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed