ESIS Senior Claims Representative, WC

Chubb•Phoenix, AZ

9d•$71,000 - $104,000

About The Position

ESIS, a Chubb company, is seeking a Senior Claims Representative to manage workers’ compensation claims from intake through resolution. The role investigates, evaluates, and resolves claims in a timely and equitable manner, following established guidelines, applicable laws, and company policies. It handles more complex files requiring advanced judgment and technical expertise and serves injured workers, employers, medical providers, clients, and other stakeholders throughout the claims process. The position involves investigating claims, assessing compensability and liability, making decisions on acceptance, denial, or settlement, maintaining accurate claim documentation, monitoring costs and reserves, and ensuring compliance with state-specific requirements. The representative collaborates with internal legal, medical, and risk management professionals. Knowledge of California and/or Nevada workers’ compensation requirements is sought. An applicable resident or designated home state adjuster’s license is required for ESIS Field Claims Adjusters; ESIS allows up to four months to pass the licensing exam for adjusters who need to obtain licensure. The pay range is $71,000 to $104,000, with the specific offer depending on skills and other factors. The role may also be eligible for a discretionary annual incentive program. Chubb offers a comprehensive benefits package; details are available on its careers website. The disclosed pay range may be adjusted for geographic differentials.

Requirements

3–5 years of experience handling workers’ compensation claims.
Knowledge of California and/or Nevada workers’ compensation requirements.
An active adjuster license or ability to obtain licensure within the required timeframe. ESIS supports independent self-study and allows up to four months to pass the adjuster licensing exam.
Ability to follow legal, regulatory, and company-specific requirements.
Ability to meet quality review expectations by following established procedures and standards.
Ability to follow ESIS best practices and client and carrier guidelines.
Strong analytical and problem-solving skills.
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.
Strong technical and professional judgment for handling more complex claims.
An applicable resident or designated home state adjuster’s license is required for ESIS Field Claims Adjusters; adjusters who do not fulfill license requirements will not meet ESIS employment requirements for handling claims.

Nice To Haves

Experience with ESIS or a similar third-party administrator.

Responsibilities

Manage workers’ compensation claims from intake through resolution, including complex files requiring advanced judgment and technical expertise.
Communicate professionally with injured workers, employers, medical providers, and other stakeholders throughout the claims process.
Investigate claims by gathering statements, reviewing medical records, and analyzing accident reports to assess compensability and liability.
Make timely, well-supported decisions about claim acceptance, denial, or settlement based on the facts and applicable laws.
Maintain accurate, organized claim files and document activities, communications, and decisions in the claims management system.
Monitor medical expenses, indemnity payments, and legal fees, and establish and maintain appropriate reserves.
Comply with state-specific workers’ compensation laws, regulations, and reporting requirements.
Respond to client inquiries, resolve issues, and provide timely claim updates.
Collaborate with internal legal, medical, and risk management professionals to support effective claim resolution.
Meet quality review expectations by following established procedures and standards.
Follow ESIS best practices and client and carrier guidelines for documentation, claims handling, and service delivery.