ESIS Senior Claims Representative, WC

JOB DESCRIPTION

Are you looking to grow your career in workers' compensation and claims support? Join ESIS, a leader in risk management and insurance services, where you can help support effective claims handling and contribute to positive outcomes for employees and clients.

We are seeking a skilled Senior Claims Representative to join our team.

Reporting to the Claims Team Leader, this role is responsible for investigating and managing claims in a timely, accurate, and equitable manner, in accordance with established best practices.

Key Responsibilities:


* Conduct thorough investigations by reviewing claims and policy information to determine the extent of the policy's obligation to the insured.


* Contact and interview insured individuals, claimants, witnesses, healthcare providers, attorneys, law enforcement, and other relevant parties to gather necessary claim information.


* Prepare detailed reports on investigations, settlements, claim denials, and evaluations of involved parties.


* Set reserves within authority limits and recommend reserve adjustments to the Team Leader.


* Regularly review claim progress with the Team Leader, identifying challenges and recommending solutions.


* Present unusual or potentially complex exposures to the Team Leader for review.


* Collaborate on improving claims handling methods and supporting a timely and equitable settlement process.


* Obtain necessary documentation, including releases, proofs of loss, or compensation agreements, and process claim payments efficiently.

QUALIFICATIONS



* Minimum of 4 years of experience handling workers' compensation claims, with demonstrated growth in a current or similar role.


* Ability to work independently with limited supervision and exercise sound judgment.


* Strong technical knowledge of claims handling processes and terminology.


* Excellent communication and interpersonal skills for working with claimants, customers, brokers, attorneys, and other stakeholders.


* Strong knowledge of the company's products, services, coverages, and policy limits, along with a solid understanding of claims best practices.


* Working knowledge of applicable state and local laws related to the line of business.


* Strong customer service skills and the ability to manage sensitive claims with professionalism and care.


* Experience handling California or Montana workers' compensation claims is preferred.

This position will report into the Portland office.

An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters.

Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims.

ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients.

ESIS' innovat...