Las Vegas, NV
3 days ago
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!

ESIS is seeking an experienced workers' compensation claims representative for the Las Vegas, NV office. The person in this role will handle and maintain all workers’ compensation claims and file reviews under the general supervision of a supervisor and as part of the ESIS team. 

Minimum Responsibilities:  

Qualified candidates must possess experience 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 NV Workers' Compensation laws and procedures is 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, and candidates must also have solid computer software skills (M/S Word, Excel). 

SPECIFIC RESPONSIBILITIES:

Determine initial reserves and provide direction to representatives as needed, identifying issues with compensability, medical conditions, subrogation, etc. Ensure that all coding and documentation are appropriate. Follow files according to diaries established by the system as well as individual claim file diaries based on the complexity of the file or customer agreements. Complete status reports for accounts as needed and participate in file reviews as required. Ensure reserve adequacy in compliance with ESIS and carrier requirements. Participate in litigation strategy sessions. Review and correct a variety of internal documents (reserves, appeals, internal audit requirements, SAS 70, etc.), sometimes completing them personally. Participate in the strategy and management of catastrophic injuries, collaborating with accounts, nurses, representatives, claims vice presidents, the home office, carriers, etc. Resolve concerns from customers, claimants, brokers, or carriers  Manage the closing of cases to ensure they move quickly and accurately. Ability to work independently while assimilating various technical components, as evidenced by successful completion of college-level curriculum or equivalent related practical work experience.  Working knowledge of Worker’s compensation Coverage, Compensability, Principles, and Practice.  Three or more years’ experience in handling Workers’ Compensation Claims. Prior experience working in a TPA environment is strongly preferred.  Determine, calculate and issue accurate benefit payments to injured workers, medical providers, and vendors in a timely fashion. Ability to remain calm and professional during peak periods of activity. Ability to organize, prioritize, and complete multiple objectives and effective use of time management skills. Strong computer skills are essential.  Self-motivation and self-starting capabilities as well as good communication and interpersonal skills; capable of dealing with accounts, injured workers, attorneys, and associates.  Ability to assist with national coordination of accounts. 

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 $65,900 to 111,900. 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 multi-line Third-Party Administrator (TPA), provides claims, risk control & loss information systems to Fortune 1000 clients across its North American platform. ESIS provides a full range of sophisticated risk management services, including workers compensation claims handling; a broad spectrum of casualty insurance products, such as general liability, automobile liability, products liability, professional liability, and medical malpractice claims handling; and disability management. 

Por favor confirme su dirección de correo electrónico: Send Email