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Full-time
professional certificate
Posted 18d ago
~40 hrs/week
Responsibilities
Manage all aspects of workers' compensation lost time claims from initial setup to closure, including investigations and benefit administration. Coordinate with attorneys, medical providers, and vendors to ensure efficient claim resolution and return-to-work initiatives.
Requirements
Requires claim adjuster licenses in Connecticut, New Hampshire, Rhode Island, and Vermont. Prior experience in workers' compensation or related claim lines is preferred, along with proficiency in Microsoft Office.
Full job description
Chubb is currently seeking a Workers’ Compensation Lost Time Claim Examiner for our Northeast, New York, and New Jersey Region. The successful applicant will be handling claims from Vermont, New Hampshire, Massachusetts, Rhode Island, Connecticut, New York, and New Jersey. The position will report to, and reside in, our New Haven, Connecticut office.
Duties & Responsibilities:
Handles all aspects of workers’ compensation lost time claims from initial set-up, to case closure, ensuring strong customer relations are maintained throughout the process.
Reviews claim and policy information to provide background for the investigation.
Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with the insured, claimant, and medical providers.
Evaluates the facts gathered through the investigation to determine the compensability for the claim.
Informs insureds, claimants, and attorneys of claim denials when applicable.
Prepare reports on investigation, settlements, denials of claims, evaluations of involved parties, etc.
Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
Sets reserves within authority limits for medical, indemnity, and expenses and recommends reserve changes to Team Leader throughout the life of the claim.
Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
Works with attorneys to manage hearings and litigation
Controls and directs vendors, nurse case managers, telephonic case managers, and rehabilitation managers on medical management and return-to-work initiatives.
Comply with customer service requests, including special claims handling procedures, file status notes, and claim reviews.
File workers’ compensation forms and electronic data with states to ensure compliance with statutory regulations.
Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
Works with in-house Technical Assistants, Special Investigators, and nurses
Consultants, telephonic case managers, and Team Supervisors to exceed customer's expectations for exceptional claims handling service.
Technical Skills & Competencies:
Lost Time Claim Examiner position with prior experience in lost time workers’ compensation is preferred but will consider training candidates with strong technical backgrounds in other claim lines or who possess complementary skillsets.
Requires knowledge of workers’ compensation statutes, regulations, and compliance.
Ability to incorporate data analytics and modeling into daily activities to expedite the fair and equitable resolution of claims and claim issues.
Exceptional customer service and focus.
Ability to openly collaborate with leadership and peers to accomplish goals.
Demonstrates a commitment to a career in claims.
Exceptional time management and multi-tasking capabilities with consistent follow-through to meet deadlines.
Use analytical skills to find mutually beneficial solutions to claims and customer issues.
Ability to prepare and make exceptional presentations to internal and external customers.
Conscientious about the quality and professionalism of work product and
relationships with co-workers and clients.
Willing to take ownership and tackle obstacles to meet Chubb's quality
standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation.
Superior verbal and written communication skills.
Experience, Education, & Requirements:
Experience working in a customer-focused, fast-paced, fluid environment
Experience utilizing strong communication and telephonic skills
Prior experience requiring a high level of organization, follow-up and accountability
Prior workers’ compensation claim handling experience is a plus but not required
Familiarity with claim handling (healthcare, short-term / long-term disability, auto personal injury protection, medical injury, or general liability) is a plus but not required
Prior insurance, medical billing, legal or corporate business experience is a plus but not required
AIC, RMA, or CPCU-completed coursework or designation(s) is a plus but not required
Proficiency with Microsoft Office Products
Knowledge of medical terminology is a plus but not required
Knowledge of bill processing is a plus but not required
Claim adjuster licenses in Connecticut (all casualty lines), New Hampshire (workers’ compensation), Rhode Island (workers’ compensation), and Vermont (workers’ compensation) are required.
If any applicant does not have the required licenses, in current standing, the applicant will have three (3) attempts or three (3) months, whichever is sooner, from the date-of-hire, to acquire the necessary licenses.
Proficiency with Microsoft Office Products
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 opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.
Chubb is a world leader in insurance. With operations in 54 countries and territories, 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. As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. The company is also defined by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength and local operations globally. Parent company Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains executive offices in Zurich, New York, London, Paris and other locations, and employs approximately 40,000 people worldwide. Additional information can be found at: www.chubb.com.
Chubb Life Hong Kong is the international life insurance division of Chubb, establishing its presence in Hong Kong since 1976. To meet the financial protection and wealth management needs of its broad range of customers, Chubb Life in Hong Kong (Chubb Life Insurance Hong Kong Limited) offers a range of life protection, savings, accident and health insurance solutions through agents and brokers. The company has been a recipient of various awards for marketing, product innovation and commitment in corporate social responsibility.
安達為全球領先的保險公司,業務遍及54個國家及地區。安達為不同行業的客戶提供商業及個人財產和責任保險、個人意外及醫療輔助保險、再保險及人壽保險等。公司的優越之處在於其多元化的產品及服務範圍、廣大的分銷能力、超卓的財務實力、出眾的理賠專業知識及營運業務遍佈全球各地。總公司安達有限公司於紐約證券交易所上市(紐約證券交易所:CB),為標準普爾500指數的成份公司。安達於蘇黎世、紐約、倫敦及其他地方設有行政辦公室,全球僱員人數約40,000名。
安達人壽是安達旗下負責國際人壽保險的分部。於亞洲,安達人壽的業務分佈在香港特別行政區、印尼、韓國、緬甸、台灣、泰國及越南等市場,並在中國設有合資企業。安達人壽自1976年踏足香港,並於2015年在香港特區開展環球財富管理業務。為滿足廣泛客戶的財務保障及財富管理需求,安達人壽香港(安達人壽保險有限公司)透過保險代理團隊及保險經紀提供一系列的人壽、儲蓄、意外和醫療保險方案。
Offices: Hong Kong, Hong Kong, HK
Life InsuranceSavings InsuranceAccident & Health InsuranceMedical InsuranceInvestment InsuranceEducation InsuranceRetirement PlanningWealth Management Solutionsand Commercial Insurance
Chubb is a world leader in insurance. With operations in 54 countries and territories, 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. As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. The company is also defined by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength and local operations globally. Parent company Chubb Limited is listed on the New York Stock Exchange (NYSE: CB) and is a component of the S&P 500 index. Chubb maintains executive offices in Zurich, New York, London, Paris and other locations, and employs approximately 40,000 people worldwide. Additional information can be found at: www.chubb.com.
Chubb Life Hong Kong is the international life insurance division of Chubb, establishing its presence in Hong Kong since 1976. To meet the financial protection and wealth management needs of its broad range of customers, Chubb Life in Hong Kong (Chubb Life Insurance Hong Kong Limited) offers a range of life protection, savings, accident and health insurance solutions through agents and brokers. The company has been a recipient of various awards for marketing, product innovation and commitment in corporate social responsibility.
安達為全球領先的保險公司,業務遍及54個國家及地區。安達為不同行業的客戶提供商業及個人財產和責任保險、個人意外及醫療輔助保險、再保險及人壽保險等。公司的優越之處在於其多元化的產品及服務範圍、廣大的分銷能力、超卓的財務實力、出眾的理賠專業知識及營運業務遍佈全球各地。總公司安達有限公司於紐約證券交易所上市(紐約證券交易所:CB),為標準普爾500指數的成份公司。安達於蘇黎世、紐約、倫敦及其他地方設有行政辦公室,全球僱員人數約40,000名。
安達人壽是安達旗下負責國際人壽保險的分部。於亞洲,安達人壽的業務分佈在香港特別行政區、印尼、韓國、緬甸、台灣、泰國及越南等市場,並在中國設有合資企業。安達人壽自1976年踏足香港,並於2015年在香港特區開展環球財富管理業務。為滿足廣泛客戶的財務保障及財富管理需求,安達人壽香港(安達人壽保險有限公司)透過保險代理團隊及保險經紀提供一系列的人壽、儲蓄、意外和醫療保險方案。
Offices: Hong Kong, Hong Kong, HK
Life InsuranceSavings InsuranceAccident & Health InsuranceMedical InsuranceInvestment InsuranceEducation InsuranceRetirement PlanningWealth Management Solutionsand Commercial Insurance