ESIS Senior Claims Representative, WC

Chubb•Phoenix, AZ

11d

About The Position

ESIS, a Chubb company, is seeking a Senior Claims Representative to manage workers’ compensation claims from intake through resolution, including complex files requiring advanced judgment and technical expertise. The role investigates, evaluates, and resolves claims in a timely and equitable manner in accordance with applicable laws, established guidelines, and company policies. It involves communicating with injured workers, employers, medical providers, and other stakeholders; analyzing claim evidence; making supported decisions; maintaining accurate claim records; monitoring costs and reserves; and collaborating with internal legal, medical, and risk management teams. The position requires knowledge of California and/or Nevada workers’ compensation requirements and an applicable adjuster license, or the ability to obtain one within the required timeframe. ESIS allows up to four months to pass the adjuster licensing exam and supports independent study time. 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; further details are available on its careers website. Pay may be adjusted for the geographic differential applicable to the position’s location.

Requirements

3–5 years of experience handling workers’ compensation claims.
Knowledge of California and/or Nevada workers’ compensation requirements.
An applicable resident or designated home state adjuster’s license, or the ability to obtain licensure within the required timeframe; ESIS allows up to four months to pass the 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 for documentation, claims handling, and service delivery.
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 complex claims.

Nice To Haves

Experience with ESIS or a similar third-party administrator.

Responsibilities

Manage workers’ compensation claims from intake through resolution, including complex claims 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 regarding claim acceptance, denial, or settlement based on case 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.
Follow established procedures and standards, along with ESIS best practices and client and carrier guidelines.