Claim Representative

JOB DESCRIPTION

Chubb is currently seeking a Workers' Compensation Medical Only Claim Examiner for our Central Region.

The successful applicant will be responsible for managing all aspects of Medical Only claims arising from various states including Illinois, Iowa, Michigan, Minnesota, and Texas.

This position offers a hybrid work schedule with a minimum of 3 days per week working from either our Dallas or Chicago Office.

Duties & Responsibilities:


* Handles all aspects of workers' compensation medical only 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 the investigation.


* Conducts three-part (insureds, claimants, and medical providers) investigations, obtaining facts and taking statements as necessary.


* Evaluates the facts gathered through the investigation to determine the compensability and relatedness of the medical treatment.


* Adhere to state regulations for assigned states.


* Adhere to Best Practice guidelines.


* Prepares reports on investigations, settlements, denials of claims, evaluations of involved parties, etc.


* Timely administration of statutory medical only benefits throughout the life of the claim.


* Sets reserves within authority limits for medical and expenses and recommends reserve changes to Supervisor throughout the life of the claim.


* Reviews the claim status at regular intervals and makes recommendations to Supervisor to discuss problems and remedial actions to resolve them.


* Controls and directs vendors and telephonic case managers on medical management.


* Complies with customer service requests, including Special Claims Handling procedures and file status notes.


* Submits workers' compensation forms and electronic data to states to ensure compliance with statutory regulations.


* Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.

Technical Skills & Competencies:


* Entry-level Medical Only Claim Examiner position.


* Knowledge of insurance, claims, and workers' compensation statutes, regulations, and compliance is a plus, but on-the-job training will be provided to the chosen applicant.


* Ability to incorporate data analytics and modeling into daily activities to expedite the fair and equitable resolution of claims and claim issues.


* A personal commitment to superior performance that adds value to our company and our customers.


* Ability to work effectively with a wide variety of people and in a team environment.


* An aptitude for evaluating, analyzing, and interpreting information.


* Superior customer service showcasing verbal, written, and interpersonal skills.


* Excellent organizational and time management skills which demonstrate the ability to multi-task and prioritize by accomplishing a high volume...