ESIS Senior Claims Representative, WC

Chubb • Tampa, FL

4d • Hybrid

About The Position

Join ESIS as a Senior Claims Representative in Tampa, FL, specializing in Workers’ Compensation. This role offers a flexible hybrid work schedule —work 3 days in the office and 2 days remotely each week —providing the balance you need to excel professionally and personally. Key Responsibilities: 🔹 Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies. Handle complex and intricate cases requiring an advanced skillset. 🔹 Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process. 🔹 Investigation: Conduct thorough investigations, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability. 🔹 Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws. 🔹 Documentation: Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system. 🔹 Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained. 🔹 Compliance: Ensure adherence to state-specific workers' compensation laws, regulations, and reporting requirements. 🔹 Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status. 🔹 Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes. As a Senior Claim Representative, you will handle more complex and intricate cases requiring advanced skills. Ready to advance your career with ESIS? Apply today and be part of a team dedicated to excellence in claims management, with the flexibility of a hybrid work environment.

Requirements

• Experience: Minimum of 5+ years handling workers' compensation claims; prior experience with ESIS or similar third-party administrators is a plus.
• Knowledge & Licensing: Knowledge of Florida Workers’ Compensation and an active adjuster license, or the ability to obtain licensure within a specified timeframe.
• Skills: Strong analytical and problem-solving abilities
• Skills: Excellent verbal and written communication skills
• Skills: Proficiency in claims management systems and Microsoft Office Suite
• Skills: Ability to manage multiple priorities and meet deadlines in a fast-paced environment
• Knowledge: Familiarity with workers' compensation laws, medical terminology, and claim handling best practices.

Nice To Haves

• prior experience with ESIS or similar third-party administrators is a plus.

Responsibilities

• Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies. Handle complex and intricate cases requiring an advanced skillset.
• Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.
• Investigation: Conduct thorough investigations, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability.
• Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws.
• Documentation: Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system.
• Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained.
• Compliance: Ensure adherence to state-specific workers' compensation laws, regulations, and reporting requirements.
• Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status.
• Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees