ESIS Claims Representative, WC

Chubb External • Cheektowaga, NY

85d

About The Position

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’re dedicated to providing exceptional service and innovative solutions, and we’re looking for passionate individuals to be part of our dynamic team. If you’re 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!

Requirements

• Strong analytical and investigative skills.
• Excellent communication and interpersonal skills.
• Ability to work collaboratively in a team environment.
• Knowledge of workers' compensation laws and regulations.
• Experience in claims management or a related field is preferred.

Nice To Haves

• Experience in risk management or insurance services.
• Familiarity with litigation processes and trial preparation.

Responsibilities

• Investigate and settle claims promptly and equitably under the direction of the Claims Team Leader.
• Receive new assignments and review claim and policy information to provide background for investigation.
• Contact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc.
• Arrange for surveys and experts where appropriate.
• Evaluate facts supplied by investigation to determine extent of liability of the insured and the company’s obligation under the policy contract.
• Prepare reports on investigation, settlements, denials of claims, and individual evaluations of involved parties.
• Set reserves within authority limits and recommend reserve changes to Team Leader.
• Review progress and status of claims with Team Leader and discuss problems and suggested remedial actions.
• Manage litigation files timely and appropriately.
• Assist Team Leader in developing methods and improvements for handling claims.
• Obtain releases, proofs of loss or compensation agreements and issue company drafts in payments for claims and expenses.
• Inform claimants, insureds/customers/agents, or attorneys of denial of claim when applicable.
• Assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements.
• Refer claims to subrogation as appropriate.
• Participate in claim file reviews and audits with customer/insured and broker.
• Administer benefits timely and appropriately and maintain control of claim’s resolution process to minimize current exposure and future risks.
• Establish and maintain strong customer relations with agents, underwriters, insureds, and experts.
• Maintain system logs, investigate compensability and benefit entitlement, review and approve medical bill payments, and manage vocational rehabilitation.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level