ESIS Claims Specialist, WC

Chubb • Irvine, CA

11h • $71,000 - $114,000

About The Position

Under the direction of the Claims Team Leader, the Workers’ Compensation Claim Specialist investigates, evaluates, and resolves claims in a timely, fair, and consistent manner, in alignment 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
• Investigation skills
• Evaluation skills
• Communication skills
• Ability to work under limited supervision

Nice To Haves

• Experience in risk management and insurance services

Responsibilities

• Work under limited supervision to receive assignments and review claim and policy information to support investigation and coverage analysis.
• Contact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to gather necessary claim information.
• Evaluate facts gathered through investigation to determine liability, if any, and the company’s obligations under the policy contract.
• Prepare reports related to investigations, settlements, claim denials, and case evaluations.
• Establish reserves within authority limits and recommend reserve changes to the Team Leader.
• Review claim progress and status with the Team Leader and discuss issues and recommended next steps.
• Prepare and submit information regarding unusual or potentially significant exposures to the Team Leader.
• Support the Team Leader in identifying process improvements and enhancing claims handling practices.
• Resolve claims in a timely and equitable manner.
• Obtain releases, proofs of loss, or compensation agreements and issue payments for claims as appropriate.
• Communicate claim denials to claimants, insureds, customers, or attorneys when applicable.

Benefits

• Equal employment opportunity
• Compliance with all laws and regulations
• 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 are the only basis upon which we hire, assign, promote, compensate, develop and retain employees.
• Prohibition of all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.

What This Job Offers

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