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Chubb · 2 weeks ago

ESIS Senior Claims Representative, WC

Dallas, TX

Full-time

Onsite

Senior Level

5+ years exp

Chubb is a world leader in insurance, committed to providing exceptional service and innovative solutions. The Workers’ Compensation Senior Claims Representative will investigate and settle claims promptly and equitably, ensuring compliance with established best practices while maintaining strong customer relations.

Commercial InsuranceFinancial ServicesHealth InsuranceInsuranceMortgageRisk Management

Responsibilities

Receive assignments

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

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 and timely issues indemnity benefits if due and owing

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

May assist Team Leader and company attorneys in preparing cases for trial by taking statements. Continues efforts to settle claims before trial

Refers claims to subrogation as appropriate

May participate in claim file reviews and audits with customer/insured and broker. Administers Workers’ Compensation benefits timely and appropriately per Jurisdiction. Maintains control of claim’s resolution process to minimize current exposure and future risks

Establishes and maintains strong customer relations

Working all queues and diary in a timely manner

Investigating compensability and benefit entitlement

Reviewing and approving medical bill payments

Managing vocational rehabilitation

Qualification

Workers' Compensation claimsClaims handling knowledgeAdjuster's licenseState laws knowledgeNegotiation skillsCommunication skillsInterpersonal skillsTime management

Required

5-7 years' experience handling Workers' Compensation claims in Louisiana and Texas

Knowledge of claims handling and familiarity with claims terminologies

Effective negotiation skills

Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses

Ability to self-motivate and work independently, excels in organization and time management skills

Knowledge of company products, services, coverages, and policy limits, along with awareness of the company's claims best practices and client service instructions

Knowledge of applicable state and local laws

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