Apply on Employer Site

Chubb · 4 days ago

ESIS Claims Representative, WC

Chatsworth, CA

Full-time

Onsite

Entry, Mid Level

$61K/yr - $93K/yr

2+ years exp

Chubb is a world leader in insurance, and they are seeking an ESIS Claims Representative to join their team. In this role, you will perform customer service and claims functions while training to become a professional claims representative, managing workers' compensation claims and ensuring compliance with applicable laws and regulations.

Commercial InsuranceFinancial ServicesHealth InsuranceInsuranceMortgageRisk Management

Hiring Manager

Jessica Hanchey

Responsibilities

Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies

Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process

Investigation: Conduct thorough investigations of claims, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability

Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws

Documentation: Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system

Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained

Compliance: Ensure adherence to state-specific workers' compensation laws, regulations, and reporting requirements

Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status

Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes

Qualification

Workers' compensation claimsClaims management systemsMicrosoft Office SuiteAnalytical skillsCommunication skillsOrganizational skillsJudgmentCommitment to excellencePositive representationMedical terminologyBest practices in claims handlingTeam collaborationCustomer focusDecision-makingAdaptability

Required

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

Preferred

A minimum of 2 years' experience in handling workers' compensation claims in California is preferred, with prior experience at ESIS or similar third-party administrators being advantageous, and/or Bachelor's degree or equivalent experience

Strong familiarity with workers' compensation laws, medical terminology, and best practices in claims handling is preferred

Demonstrated proficiency in claims management systems and the Microsoft Office Suite

Excellent written and verbal communication skills, enabling effective interactions with external investigative sources and insureds over the phone

Proven ability to contribute effectively within a team environment, providing and receiving constructive feedback while identifying growth opportunities for both self and colleagues

Strong analytical and problem-solving abilities to navigate complex scenarios efficiently

Capable of managing multiple priorities and meeting deadlines in a fast-paced work environment

Strong commitment to customer service, with a proactive approach to addressing and supporting customer needs

Confidence in personal judgment, with the ability to support and defend decisions made

Dedicated to maintaining high standards of behavior and performance

Flexible in adapting approaches and behaviors to fit specific situations effectively

Strong focus on building and maintaining a positive image for Chubb and ESIS