KEY OBJECTIVE:
Responsibilities include investigating claims to determine extent of injury, reserving and effective case management. Utilize medical cost containment measures to control loss dollar pay-out. Review status of claims and develop strategies to effectively manage to conclusion. Consistent delivery of superior customer service.
MAJOR DUTIES & RESPONSIBILITIES:
Handle multiple demands & priorities, from a variety of sources, simultaneously
Maintain ESIS Standards & Best Practices
Adjust claims with the ability to follow company policies and procedures
Have the ability to effectively and independently manage and maintain a workers compensation pending.
Handle and resolve conflict effectively
Meet goals & objectives established by ESIS and the Claims Vice President
Escalate issues appropriately and follow through
Be a problem solver with excellent problem resolution skills
Meet and maintain customer service requirements and have the ability to follow ESIS processes.
Make sound judgment decisions and have the ability to differentiate information.
Communicate effectively both written & orally
Respond to customers appropriately, timely & accurately
Ability to remain calm and professional during peak periods of activity.
Handle multiple computer applications and vendor systems to manage caseloads
Identify and determine short term and long term financial exposures and establish accurate financial reserves to meet Client, ESIS and Carrier expectations
Effectively and accurately manage large sums of client or carrier funds
Comply with all statutory reporting and licensing requirements for multiple jurisdictions
Determine, calculate and issue accurate benefit payments to injured workers, medical providers and vendors in a timely fashion
Clearly and concisely document the ESIS claim system with activities, investigations and plans in a timely fashion
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.
Qualified candidates must possess experience 5 or more years in managing workers compensation claims investigation/ adjusting, including knowledge of applicable state/local legislation.
Experience in a third party administrator (TPA) environment is a plus.
Knowledge of Workers'' Compensation laws and procedures are required.
Candidates must have the ability to work independently, while assimilating various technical subjects, as evidenced by successful completion of a college degree or equivalent practical work experience.
AIC/CPCU is preferred
Candidates must also have solid computer software skills (M/S Word, Excel).
Chubb is the world’s largest publicly traded property and casualty insurance company and the largest commercial insurer in the U.S.
With operations in 54 countries and territories, we are a major personal lines writer, as well as a leading middle market, small commercial and large industrial commercial insurer, providing a wide range of traditional and specialty coverages.
As an underwriting company, we assess, assume and manage risk with insight and discipline. We service and pay our claims fairly and promptly. And we combine the precision of craftsmanship with deep experience to conceive, craft and deliver the very best insurance coverage and service to individuals and families and to businesses of all sizes.
Our products and services are distributed through brokers, independent agents, exclusive agents and various forms of direct marketing.
What we deliver: