ESIS Senior Recovery Representative

JOB DESCRIPTION

The ESIS Senior Recovery Representative is responsible for managing workers' compensation recovery files, supporting subrogation efforts, and coordinating with internal and external stakeholders to advance claim resolution.

This role requires strong analytical skills, sound judgment, and the ability to manage a high-volume caseload while maintaining accurate records, meeting service expectations, and supporting recovery objectives.

Reporting Structure
This position reports directly to the RSI Manager/Supervisor within the Workers' Compensation Subrogation unit.

Key Responsibilities

Technical and Quality File Handling


* Maintain high-quality recovery file handling, with a target average quality review score of 90% or higher.


* Maintain diaries to ensure no item exceeds 30 days from the current date.


* Apply fees to recoveries accurately and consistently, with a target success rate of 95% or higher.


* Maintain a closing ratio of at least 100%.


* Index all emails and attached documents into the claim system within 5 business days of receipt, with a target compliance rate of 90% or higher.


* Complete preliminary reviews of all new referrals within 5 business days of assignment.


* Contribute to RSI's overall revenue and recovery goals.


* Maintain accurate data entry and billing records.


* Develop proficiency in claims and subrogation management systems.

Strategic Case Management and Stakeholder Relations


* Maintain professional business relationships with key internal and external contacts.


* Identify efficient case handling approaches to support timely file closure and settlement where appropriate.


* Direct investigations, evaluate third-party liability, pursue subrogation recoveries, and negotiate settlements for workers' compensation and/or AGL claims across multiple jurisdictions.


* Manage litigated files and coordinate with subrogation counsel as appropriate.


* Follow through on promise-to-pay cases after settlement has been reached.


* Respond promptly and professionally to client and Account Executive inquiries.


* Provide accurate and timely claim review status reports to relevant stakeholders.


* Participate in claim reviews with claim staff as requested.

Customer Service


* Follow recovery instructions and established service protocols on an account-by-account basis.


* Provide thoughtful and timely responses to management and customer inquiries.


* Participate in claim reviews as directed by management.


* Provide training and knowledge sharing to ESIS/Chubb staff as requested by RSI Management.


* Develop and maintain strong business relationships with key clients, claim staff, and Account Executives.

QUALIFICATIONS



* College degree and state licenses preferred.


* 5 to 7 years of experience handling workers' compensation claims.


* Prior experience in workers' compensation claims handling, subrogati...