ESIS Senior Claims Representative, WC

Chubb•Portland, OR

6d•$65,900 - $111,900•Hybrid

About The Position

Are you ready to make a meaningful impact in the world of workers' compensation? 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! The ESIS Senior Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines. Duties include but are not limited to: Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business. Contacts, interviews, and obtains statements from insured parties, claimants, witnesses, physicians, attorneys, police officers, and other relevant individuals to secure necessary claim information. Evaluates facts supplied by investigation to determine the extent of liability of the insured, if any, and the extent of the company’s obligation to the insured under the policy contract. Prepares reports on investigations, settlements, denials of claims, and individual evaluations of involved parties. Sets reserves within authority limits and recommends reserve changes to the Team Leader. Reviews progress and status of claims with the Team Leader and discusses problems and suggested remedial actions. Prepares and submits to the Team Leader unusual or potentially undesirable exposures. Assists the Team Leader in developing methods and improvements for handling claims. Settles claims promptly and equitably. Obtains releases, proofs of loss, or compensation agreements and issues company drafts in payment for claims. Informs claimants, insured parties/customers, or attorneys of denial of claim when applicable.

Requirements

An applicable resident or designated home state adjuster’s license is required for ESIS Field Claims Adjusters.
Adjusters that do not fulfill the license requirements will not meet ESIS’s employment requirements for handling claims.

Nice To Haves

4 or more years of experience handling workers’ compensation claims.
Strong communication and interpersonal skills to effectively interact with claimants, customers, insured parties, brokers, attorneys, and others in a positive manner regarding losses.
Ability to self-motivate and work independently.
Knowledge of company products, services, coverages, and policy limits, along with awareness of the company’s claims best practices.
Effective negotiation skills.
Preference for candidates with experience handling workers’ compensation claims in California, Idaho, or Oregon.

Responsibilities

Receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business.
Contacts, interviews, and obtains statements from insured parties, claimants, witnesses, physicians, attorneys, police officers, and other relevant individuals to secure necessary claim information.
Evaluates facts supplied by investigation to determine the extent of liability of the insured, if any, and the extent of the company’s obligation to the insured under the policy contract.
Prepares reports on investigations, settlements, denials of claims, and individual evaluations of involved parties.
Sets reserves within authority limits and recommends reserve changes to the Team Leader.
Reviews progress and status of claims with the Team Leader and discusses problems and suggested remedial actions.
Prepares and submits to the Team Leader unusual or potentially undesirable exposures.
Assists the Team Leader in developing methods and improvements for handling claims.
Settles claims promptly and equitably.
Obtains releases, proofs of loss, or compensation agreements and issues company drafts in payment for claims.
Informs claimants, insured parties/customers, or attorneys of denial of claim when applicable.