ESIS ProClaim Senior Specialist

JOB DESCRIPTION

ESIS ProClaim is seeking an experienced Senior Claims Specialist.

Under the direction of the AVP and VP of Claims and Claims Team Leader you will review coverage, investigate facts of third-party property claims, secure evidence, assess and address subrogation/recovery/tenders, apportion liability and settle claims at the best outcome within established claim best practices guidelines and client instructions.

Duties include but are not limited to:


* Determine coverage, conducts a thorough investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.


* Maintain diary system to ensure each file is reviewed at a minimum of every 90 days.


* Effectively work with defense counsel and litigation working collaboratively, as directed by the client.


* Ensure detailed 90-day Claim Summary Reports are prepared and provide updates to the client on investigation, potential settlement opportunities, claim denials, reservation of rights, third party tenders and recommendations to present at claims review meetings.


* Posts loss and expense reserves in Claims system within authority limits and recommends reserve changes above authority to AVP and/or VP of Claims.


* Reviews progress and status of claims with claims leadership and discusses issues/opportunities/task and remedial actions.


* Prepares and submits to claims leadership all unusual or potentially undesirable exposures such as allegations of bad faith or unfair claim practice allegations.


* Assists Claims Leadership in formulating improvements in claims handling procedures.


* Assist and works with Partnership Leaders on delivering results, attend meetings and claim reviews.


* Reviews and confirms claims professionals have secured the appropriate releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.


* Maintains claims with the appropriate file notes, reports, photos, and documentation within the claim.


* Follows all company and regulatory compliance requirements.


* Updates claim timely with Medicare data and addresses Medicare reporting & interest.


* Meets or exceeds performance goals.

QUALIFICATIONS

ABOUT US

Chubb is a world leader in insurance.

With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients.

The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it.

Our policy is to provide employment, training, compensation, promotion, and other conditions or oppo...