ESIS Claims Specialist, 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 are dedicated to providing exceptional service and innovative solutions, and we are looking for passionate individuals to be part of our dynamic team.

If you are 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!

We are seeking a skilled Claims Specialist to enhance our team.

Reporting to the Claims Team Leader, this role plays a vital part in investigating and managing claims promptly and equitably, in line with established best practices.

This is a hybrid position, with three days per week in-office in Chatsworth.

For experienced individuals who are more than an hour from a local office, fully remote may be possible.

Duties include but are not limited to:


* Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.


* Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc.

to secure necessary claim information.


* Depending on line of business may inspect and appraise damage for property losses or arranges for such appraisal.


* Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company's obligation to the insured under the policy contract.


* Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.


* Sets reserves within authority limits and recommends reserve changes to Team Leader.


* Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.


* Prepares and submits to Team Leader unusual or possible undesirable exposures.


* Assists Team Leader in developing methods and improvements for handling claims.


* Settles claims promptly and equitably.


* Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.

Informs claimants, insureds/customers or attorney of denial of claim when applicable.

QUALIFICATIONS



* 5 or more years' experience handling workers' compensation claims as evidenced by career progression within the company or similar organization.


* Ability to work independently with limited direction from a Team Leader.


* Authoritative technical knowledge of claims handling and claims terminologies.


* Superior negotiat...