ESIS Senior Claims Representative, WC

Chubb•Las Vegas, NV

About The Position

ESIS, a Chubb company, is seeking a Senior Claims Representative to investigate and manage workers’ compensation claims promptly, accurately, and equitably in accordance with applicable laws, company policies, and established best practices. The role reports to the Claims Team Leader and handles complex claims requiring an advanced skillset. It involves coordinating with injured workers, employers, medical providers, clients, and internal legal, medical, and risk management teams to support effective claims outcomes. The representative investigates claims, determines compensability and liability, makes decisions on acceptance, denial, or settlement, and maintains thorough claim documentation. The role also includes monitoring claim costs and reserves, ensuring compliance with state-specific requirements, providing responsive customer service, and following ESIS, client, and carrier guidelines. Knowledge of Nevada and/or California workers’ compensation is sought, and an applicable adjuster’s license is required for ESIS Field Claims Adjusters. ESIS allows up to four months for independent study and passing the licensing exam where needed. ESIS provides claim and risk management services to commercial clients in the U.S. and globally, with more than 70 years of experience. The pay range is $78,100 to $105,000, depending on skills and other factors, with possible eligibility for a discretionary annual incentive program. Chubb offers a comprehensive benefits package; details are available on its careers website. The pay range may be adjusted based on geographic differential.

Requirements

Minimum of 3–5 years of experience handling workers’ compensation claims.
Knowledge of Nevada and/or California workers’ compensation.
Active adjuster license or ability to obtain licensure within the specified timeframe; an applicable resident or designated home state adjuster’s license is required for ESIS Field Claims Adjusters.
Strong analytical and problem-solving abilities.
Excellent verbal and written communication skills.
Proficiency with claims management systems and Microsoft Office Suite.
Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Familiarity with workers’ compensation laws, medical terminology, and claim-handling best practices.
Compliance with legal, regulatory, company, client, and carrier requirements and established procedures.

Nice To Haves

Prior experience with ESIS or similar third-party administrators.

Responsibilities

Investigate, evaluate, and manage workers’ compensation claims from inception through resolution.
Communicate with injured workers, employers, medical providers, and other stakeholders throughout the claims process.
Gather statements, review medical records, and analyze accident reports to determine compensability and liability.
Make timely decisions regarding claim acceptance, denial, or settlement based on case facts and applicable laws.
Maintain detailed and organized claim files, documenting activities, communications, and decisions in the claims management system.
Monitor claim costs, including medical expenses, indemnity payments, and legal fees, and establish and maintain appropriate reserves.
Ensure compliance with state-specific workers’ compensation laws, regulations, and reporting requirements.
Respond to client inquiries, resolve issues, and provide timely claim-status updates.
Collaborate with legal, medical, and risk management professionals to achieve optimal claim outcomes.
Follow ESIS best practices and client and carrier guidelines for documentation, claims handling, and service delivery.