ESIS Senior Claims Representative, WC

Chubb • Phoenix, AZ

1d • Hybrid

About The Position

ESIS is seeking a skilled Senior Claims Representative to enhance their team. Reporting to the Claims Team Leader, this role plays a vital part in investigating and managing claims promptly and equitably, in line with established best practices. This is a hybrid position, with three days per week in-office. The ESIS Senior Nevada Claim Representative, under the direction of the Claims Team Leader, investigates and resolves claims promptly, equitably, and in accordance with established best practices.

Requirements

• Workers' compensation claims management experience
• Advanced skills for handling complex claims
• Knowledge of applicable laws, regulations, and company policies
• Ability to conduct thorough investigations
• Proficiency in making timely and accurate claim decisions
• Skill in maintaining detailed and organized claim files
• Ability to monitor and manage claim costs
• Knowledge of state-specific workers' compensation laws and regulations
• Exceptional customer service skills
• Ability to collaborate with internal teams

Nice To Haves

• Experience in a Senior Claims Representative role
• Experience with ESIS claims management system

Responsibilities

• Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies. The Senior Claim Representative handles more complex and intricate claims, requiring advanced skills.
• 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.
• 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 exceptional 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 achieve optimal claim outcomes.

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 as the only basis for hiring, assignment, promotion, compensation, development, and retention.
• Prohibition of unlawful discrimination, harassment, and retaliation.

What This Job Offers

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