ESIS Claims Representative, WC at Chubb

Tampa, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Sep, 26

Salary

0.0

Posted On

11 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Workers' Compensation Claims Handling, Claims Investigation, Liability Evaluation, Reserve Setting, Medical Terminology, Claims Management Systems, Microsoft Office Suite, Written Communication, Verbal Communication, Analytical Problem Solving, Customer Service, Decision Making, Case Preparation, Audit Participation, Benefit Administration, Negotiation

Industry

Insurance

Description

Major Duties & Responsibilities * Under close supervision, receive assignments and review 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. * Contact, interview, and obtain statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc., to secure necessary claim information. * Evaluate facts supplied by the investigation to determine the extent of liability of the insured, if any, and the extent of 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. * Prepare and submit to the Team Leader any unusual or potentially undesirable exposures. * 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 payments on claims. * Inform claimants, insureds/customers, or attorneys of claim denials when applicable. * Assist the Team Leader and company attorneys in preparing cases for trial by arranging for witness attendance and taking statements. Continue efforts to settle claims before trial. * Participate in claim file reviews and audits with customers/insureds and brokers. * Administer benefits timely and appropriately. Maintain control of the claims resolution process to minimize current exposure and future risks. 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.

Responsibilities

The role involves investigating workers' compensation claims, interviewing involved parties, and determining liability and policy obligations. The representative is responsible for setting reserves, settling claims equitably, and preparing cases for trial when necessary.