ESIS Claims Specialist, WC

Chubb•Great Falls, MT

6d•$71,000 - $104,000

About The Position

Under the direction of the Claims Team Leader, the ESIS Claims Specialist investigates, evaluates, and settles claims promptly, fairly, and in accordance with established best practices and company guidelines. This role is an opportunity to grow a career in workers’ compensation and claims support, helping to support effective claims handling and contribute to positive outcomes for employees and clients.

Requirements

Investigates, evaluates, and settles claims promptly, fairly, and in accordance with established best practices and company guidelines.
Ability to receive assignments and review claim and policy information to support investigation and determine policy obligations.
Skill in contacting and interviewing various parties (insureds, claimants, witnesses, physicians, attorneys, police officers) to gather claim information.
Proficiency in evaluating facts to determine liability and company obligations.
Experience in preparing reports on investigations, settlements, claim denials, and evaluations.
Ability to establish reserves within authority limits and recommend changes.
Capability to review claim progress and status, discuss issues, and recommend corrective actions.
Skill in submitting unusual or potentially adverse exposures for review.
Ability to assist in developing process improvements for claims handling.
Experience in settling claims promptly and equitably.
Proficiency in obtaining releases, proofs of loss, or compensation agreements.
Ability to issue company drafts for claim payments.
Experience in notifying claimants, insureds/customers, or attorneys of claim denials.

Nice To Haves

Workers' compensation claims experience
Claims support experience

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 the insured’s liability, if any, and the company’s obligation under the policy contract.
Prepares reports related to investigations, settlements, claim denials, and evaluations of involved parties.
Establishes 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 process improvements and enhanced methods for handling claims.
Settles claims promptly and equitably.
Obtains releases, proofs of loss, or compensation agreements and issues company drafts for claim payments.
Notifies claimants, insureds/customers, or attorneys of claim denials when applicable.