ESIS Senior Claims Representative, WC

Chubb • Phoenix, AZ

2d • $71,000 - $104,000

About The Position

Are you interested in building your career in workers’ compensation and claims support? Join ESIS, a leader in risk management and insurance services, where you can contribute to effective claims handling and support employees during important moments. Under the direction of the Claims Team Leader, the ESIS Senior Claim Representative investigates and resolves claims promptly, fairly, and in accordance with established best practices. This role handles more complex claims and requires strong technical skills.

Requirements

• Strong technical skills for handling complex claims.

Responsibilities

• Investigate, evaluate, and manage workers’ compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies.
• Serve as a primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.
• Conduct thorough investigations of claims, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability.
• Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws.
• Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system.
• Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained.
• Ensure adherence to state-specific workers’ compensation laws, regulations, and reporting requirements.
• Provide responsive service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status.
• Work closely with internal teams, including legal, medical, and risk management professionals, to support effective claim outcomes.

What This Job Offers

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