ESIS Claims Representative, WC

ESIS Claims Representative, WC 

Locations: Cheektowaga, VA | Philadelphia, PA 

Work Arrangement
This role follows a hybrid schedule of 3 days in office and 1 day remote.

Key Objective
Under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably, and within established best practices guidelines.

Major Duties & Responsibilities
Duties may include, but are not limited to:

• Receive new assignments.
• Review claim and policy information to provide background for investigation and determine the extent of the policy’s obligation to the insured, depending on the line of business.
• Contact, interview, and obtain statements, recorded or in person, from insureds, claimants, witnesses, physicians, attorneys, police officers, and others to secure necessary claim information.
• Arrange for surveys and experts where appropriate.
• Evaluate facts supplied by investigation to determine the extent of liability of the insured, if any, and the company’s obligation to the insured under the policy contract.
• Prepare reports on investigations, settlements, denials of claims, and individual evaluations of involved parties.
• Set reserves within authority limits and recommend reserve changes to the Team Leader.
• Review progress and status of claims with the Team Leader and discuss problems and suggested remedial actions.
• Manage litigation files in a timely and appropriate manner.
• Assist the Team Leader in developing methods and improvements for handling claims.
• Settle claims promptly and equitably.
• Obtain releases, proofs of loss, or compensation agreements and issue company drafts for claim and expense payments.
• Inform claimants, insureds, customers, agents, or attorneys of claim denials when applicable.
• Assist the Team Leader and company attorneys in preparing cases for trial by arranging witness attendance and taking statements; continue efforts to settle claims before trial.
• Refer claims to subrogation as appropriate.
• Participate in claim file reviews and audits with customers, insureds, and brokers.
• Administer benefits timely and appropriately, maintaining control of the claim resolution process to minimize current exposure and future risks.
• Establish and maintain strong customer relations with agents, underwriters, insureds, and experts.

Depending on Line of Business, Other Duties May Include

• Maintaining system logs
• Investigating compensability and benefit entitlement
• Reviewing and approving medical bill payments or forwarding for outside review as necessary
• Managing vocational rehabilitation

Scope Information
The position reports directly to a Claims Team Leader or other member of claims management.

Qualifications

What You’ll Need

• 1–2 years of experience handling higher-level Workers’ Compensation claims.
• Basic knowledge of claims handling and familiarity with claims terminology.
• Effective negotiation skills.
• Strong communication and interpersonal skills with the ability to deal positively with claimants, customers, insureds, brokers, attorneys, and others regarding losses.
• Ability to self-motivate and work independently.
• Knowledge of ACE products, services, coverages, and policy limits, along with awareness of ACE claims best practices.
• Knowledge of applicable state and local laws.
• State adjuster’s licensing is a plus, or future licensing may be required.
• Familiarity with computer systems.
• Typing speed of 40 words per minute.

The pay range for the role is $57,000 to  $83,000. The specific offer will depend on an applicant’s skills and other factors. This role may also be eligible to participate in a discretionary annual incentive program.  Chubb offers a comprehensive benefits package, more details on which can be found on our careers website.  The disclosed pay range estimate may be adjusted for the applicable geographic differential for the location in which the position