ESIS Senior Claims Representative, WC

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we’re dedicated to providing exceptional service and innovative solutions, and we’re looking for passionate individuals to be part of our dynamic team. If you’re eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

Reporting to the Claims Team Leader, the ESIS Senior Claim Representative is responsible for investigating and resolving workers’ compensation claims promptly, equitably, and in accordance with established best practices. This role handles complex and intricate claims, requiring advanced expertise and judgment.

Duties include, but are not limited to:

• With limited supervision, receives assignments and reviews claim and policy information to provide background for investigations, and may determine the extent of the policy’s obligation to the insured, depending on the line of business.
• Contacts, interviews, and obtains statements from insured parties, claimants, witnesses, medical professionals, attorneys, law enforcement, and other relevant individuals to gather necessary claim information.
• Evaluates facts obtained during investigations to determine the extent of liability and the company’s obligation under the policy contract.
• Prepares reports on investigations, settlements, claim denials, and individual evaluations of involved parties.
• Sets reserves within designated authority limits and recommends reserve adjustments to the Team Leader as needed.
• Reviews the progress and status of claims with the Team Leader, discussing challenges and recommending remedial actions.
• Prepares and submits reports to the Team Leader regarding unusual or potentially undesirable exposures.
• Assists the Team Leader in developing methods and improvements for handling claims.
• Settles claims promptly and fairly.
• Obtains releases, proofs of loss, or compensation agreements, and issues company drafts for claim payments.
• Notifies claimants, insureds, customers, or attorneys of claim denials when applicable.

• Minimum of four years’ experience handling workers’ compensation claims.
• Strong communication and interpersonal skills for positive and effective interactions with claimants, customers, insureds, brokers, attorneys, and other stakeholders.
• Proven ability to work independently and demonstrate self-motivation.
• Solid understanding of company products, services, coverages, policy limits, and claims best practices.
• Effective negotiation skills.
• Experience handling workers’ compensation claims in California or Oregon is preferred.

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. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam.

The pay range for the role is $71,000 to $104,000. 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 is filled.

ESIS, a Chubb company, provides claim and risk management services to a wide variety of commercial clients. ESIS’ innovative best-in-class approach to program design, integration, and achievement of results aligns with the needs and expectations of our clients’ unique risk management needs. With more than 70 years of experience, and offerings in both the U.S. and globally, ESIS provides one of the industry’s broadest selections of risk management solutions covering both pre- and post-loss services.