Workers' Compensation Senior WC Claims Specialist
JOB DESCRIPTION
Chubb is currently seeking a Workers' Compensation Lost Time Claim Examiner for our Chicago office.
The successful applicant will be handling claims from multiple jurisdictions in the Midwest.
The position will report to a Claim Manager in Chicago and must report to the Chicago, Dallas or Troy offices a minimum of 3 days per week.
This is not a remote position.
This position is a 3/2 Hyrbid Model.
* Independently handles all aspects of workers' compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
* Reviews claim and policy information to provide background for investigation.
* Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers.
* Evaluates the facts gathered through the investigation to determine compensability of the claim.
* Informs insureds, claimants, and attorneys of claim denials when applicable.
* Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
* Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
* Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim.
* Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
* Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
* Works with attorneys to manage hearings and litigation
* Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.
* Complies with customer service requests including Special Claims Handling procedures, file status notes and claim reviews.
* Files workers' compensation forms and electronic data with states to ensure compliance with statutory regulations.
* Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
* Works with in-house Technical Assistants, Special Investigators, Nurse
Consultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.
Technical Skills & Competencies:
* Lost Time Claim Examiner position with prior experience in workers' compensation or similar examiner experience
* Works with a high degree of autonomy and showcases venue expertise
* Requires knowledge of workers' compensation statutes, regulations, and compliance
* Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues
* Exceptional customer ser...
- Rate: Not Specified
- Location: Chicago, US-IL
- Type: Permanent
- Industry: Finance
- Recruiter: Chubb
- Contact: Not Specified
- Email: to view click here
- Reference: 5243
- Posted: 2024-03-14 07:26:26 -
- View all Jobs from Chubb
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