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ESIS Claims Team Leader, WC

JOB DESCRIPTION

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need.

At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team.

If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

ESIS is looking to hire a Workers' Compensation Team Leader to supervise and direct the activities of Claims Representatives, Specialists, Claims Assistants, and/or other clerical support positions in the investigation and management of workers' compensation claims to ensure prompt, efficient, and fair claims handling.

Ensure a high level of customer service and claim file quality.

GENERAL RESPONSIBILITIES:


* Improve the technical quality of files within the team.


* Act as a team facilitator to help remove barriers and take an active role in resolving team issues.


* Be an integral member of the Claims Office Workers' Compensation Management Team.


* Be responsible for ongoing team development, ensuring effective loss dollar management, and providing value-added customer service.


* Maintain a strong commitment to team building and ESIS management principles.


* Understand and utilize current information systems.


* Collect and analyze data to identify individual opportunities for improvement.


* Work with individuals to assess their knowledge and skill gaps and develop plans for enhancement.


* Promote ESIS Claims Management Division strategies and values.


* Address Human Resource issues and problems effectively.


* Demonstrate a proactive approach to servicing external and internal customers.


* Show understanding and ability to apply the technical aspects of claims handling.


* Provide one-on-one coaching and counseling to team members.


* Effectively evaluate programs and procedures for continuous improvement.

SPECIFIC RESPONSIBILITIES:


* Review and assign all new claims based on customer needs and claim complexity.


* Determine initial reserves and provide direction to representatives as needed, identifying issues with compensability, medical conditions, subrogation, etc.


* Ensure that all coding and documentation are appropriate.


* Follow files according to diaries established by the system as well as individual claim file diaries based on the complexity of the file or customer agreements.


* Review files at key checkpoints for investigation, medical management, subrogation, statutory requirements (forms, etc.), reserve accuracy, fraud indicators, and provide guidance on ESIS best practi...




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