ESIS Claims Representative, WC

Chubb•Cheektowaga, NY

5d•Hybrid

About The Position

Under the direction of a Claims Team Leader, the ESIS Claims Representative investigates and settles Workers’ Compensation claims promptly and equitably, following established best-practice guidelines. The role reviews claim and policy information, investigates liability and coverage, evaluates benefits and reserves, manages claims through resolution and litigation, and maintains effective relationships with customers and other parties. The position reports directly to a Claims Team Leader or another member of claims management. The role follows a hybrid schedule of three days in the office and one day remote. Locations listed are Cheektowaga, VA and Philadelphia, PA. The pay range is $57,000 to $83,000, with the specific offer dependent on applicant skills and other factors. The role may also be eligible for a discretionary annual incentive program. Chubb offers a comprehensive benefits package; further details are available on its careers website.

Requirements

1–2 years of experience handling higher-level Workers’ Compensation claims.
Basic knowledge of claims handling and familiarity with claims terminology.
Effective negotiation skills.
Strong communication and interpersonal skills, including the ability to deal positively with claimants, customers, insureds, brokers, attorneys, and others regarding losses.
Ability to self-motivate and work independently.
Knowledge of ACE products, services, coverages, and policy limits, and awareness of ACE claims best practices.
Knowledge of applicable state and local laws.
Familiarity with computer systems.
Typing speed of 40 words per minute.

Nice To Haves

State adjuster’s license; future licensing may be required.

Responsibilities

Receive new claim assignments and review claim and policy information to establish investigative background and determine policy obligations.
Contact, interview, and obtain recorded or in-person statements from insureds, claimants, witnesses, physicians, attorneys, police officers, and others.
Arrange surveys and expert services when appropriate.
Evaluate investigative facts to determine insured liability and the company’s obligations under the policy.
Prepare reports concerning investigations, settlements, claim denials, and evaluations of involved parties.
Set reserves within authority limits and recommend reserve changes to the Team Leader.
Review claim progress and status with the Team Leader and discuss problems and proposed remedial actions.
Manage litigation files in a timely and appropriate manner.
Assist the Team Leader in developing methods and improvements for claims handling.
Settle claims promptly and equitably; obtain releases, proofs of loss, or compensation agreements and issue company drafts for claim and expense payments.
Inform claimants, insureds, customers, agents, or attorneys of claim denials when applicable.
Assist the Team Leader and company attorneys with trial preparation, including arranging witness attendance and taking statements, while continuing efforts to settle claims before trial.
Refer claims to subrogation when appropriate.
Participate in claim file reviews and audits with customers, insureds, and brokers.
Administer benefits timely and appropriately and maintain control of claim resolution to minimize current exposure and future risks.
Establish and maintain strong customer relationships with agents, underwriters, insureds, and experts.
Depending on line of business, maintain system logs; investigate compensability and benefit entitlement; review and approve medical bill payments or forward them for outside review; and manage vocational rehabilitation.