Job DescriptionUnder the direction of the Claims Team Leader, the Workers' Compensation Claim Specialist investigates, evaluates, and resolves claims in a timely, fair, and consistent manner, in alignment with established best practices.
Major Duties and ResponsibilitiesDuties include, but are not limited to:
- Work under limited supervision to receive assignments and review claim and policy information to support investigation and coverage analysis.
- Contact, interview, and obtain statements from insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to gather necessary claim information.
- Evaluate facts gathered through investigation to determine liability, if any, and the company's obligations under the policy contract.
- Prepare reports related to investigations, settlements, claim denials, and case evaluations.
- Establish reserves within authority limits and recommend reserve changes to the Team Leader.
- Review claim progress and status with the Team Leader and discuss issues and recommended next steps.
- Prepare and submit information regarding unusual or potentially significant exposures to the Team Leader.
- Support the Team Leader in identifying process improvements and enhancing claims handling practices.
- Resolve claims in a timely and equitable manner.
- Obtain releases, proofs of loss, or compensation agreements and issue payments for claims as appropriate.
- Communicate claim denials to claimants, insureds, customers, or attorneys when applicable.
Qualifications- 4 or more years of experience handling workers' compensation claims
- Strong written and verbal communication skills, with the ability to interact professionally with claimants, customers, insureds, brokers, attorneys, and other stakeholders
- Ability to work independently and manage priorities effectively
- Knowledge of company products, services, coverages, policy limits, and claims best practices
- Strong negotiation skills
- Experience handling workers' compensation claims in California or Hawaii 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 $114,000. 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.
