ESIS Claims Representative, WC

ESIS Claims Representative, WC

Locations: Cheektowaga, VA | Philadelphia, PA

Work Arrangement
This role follows a hybrid schedule of 3 days in office and 1 day remote .

Key Objective
Under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably, and within established best practices guidelines.

Major Duties & Responsibilities
Duties may include, but are not limited to:

- Receive new assignments.
- Review claim and policy information to provide background for investigation and 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, and others to secure necessary claim information.
- Arrange for surveys and experts where appropriate.
- Evaluate facts supplied by investigation to determine the extent of liability of the insured, if any, and 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.
- Manage litigation files in a timely and appropriate manner.
- 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 claim and expense payments.
- Inform claimants, insureds, customers, agents, or attorneys of claim denials when applicable.
- Assist the Team Leader and company attorneys in preparing cases for trial by arranging witness attendance and taking statements; continue efforts to settle claims before trial.
- Refer claims to subrogation as appropriate.
- Participate in claim file reviews and audits with customers, insureds, and brokers.
- Administer benefits timely and appropriately, maintaining control of the claim resolution process to minimize current exposure and future risks.
- Establish and maintain strong customer relations with agents, underwriters, insureds, and experts.

Depending on Line of Business, Other Duties May Include

- Maintaining system logs
- Investigating compensability and benefit entitlement
- Reviewing and approving medical bill payments or forwarding for outside review as necessary
- Managing vocational rehabilitation

Scope Information
The position reports directly to a Claims Team Leader or other member of claims management.

What You’ll Need

- 1–2 years of experience handling higher-level Workers’ Compensation claims.
- Basic knowledge of claims handling and familiarity with claims terminology.
- Effective negotiation skills.
- Strong communication and interpersonal skills with the ability to deal positively with claimants, customers, insureds, brokers, attorneys, and others regarding losses.
- Ability to self-motivate and work independently.
- Knowledge of ACE products, services, coverages, and policy limits, along with awareness of ACE claims best practices.
- Knowledge of applicable state and local laws.
- State adjuster’s licensing is a plus, or future licensing may be required.
- Familiarity with computer systems.
- Typing speed of 40 words per minute.

The pay range for the role is $57,000 to $83,000. 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