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Claim Examiner in Los Angeles, CA at Chubb Group of Insurance Companies

Date Posted: 8/11/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    515 South Flower Street
    Los Angeles, CA
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    8/11/2018

Job Description

Job Description: WC Claims Specialist (Job Number )
Description
Chubb is the world’s largest publicly traded property and casualty insurer. 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. 
 

Job Summary/Duties
Workers Compensation Claim Specialist handles a caseload of approx 150 litigated and non-litigated claims, most involving lost time and permanent disability with some complex medical only claims. Claims Specialist is responsible for all aspects of claim handling including initial and subsequent investigations, benefit administration, reserves, litigation, and case resolution.
Claims Specialist will handle files from both dedicated and non-dedicated accounts, some of which will require periodic claim reviews and notifications of reserves and settlement. Claims Specialist will handle CA claims with experience handling AZ, CO and UT claims is a plus.   
Claim Specialist will be expected to
  • use effective diary management, file documentation, and action plans to close files promptly   
  • leverage internal/external resources to make appropriate, timely decisions within  authority
  • conduct/collaborate with internal investigators on compensability, fraud and subrogation investigations
  • manage/collaborate with internal nurse resources on return to work and treatment issues
  • direct/collaborate with internal resources to meet state compliance requirements for accurate benefit administration
  • demonstrate timely exposure recognition to calculate accurate reserves and settlements
  • document thorough reserve and settlement rationales for internal/external customers
  • use proactive communication skills to address/avoid account management issues  
Job Qualifications
  • Solid knowledge of CA jurisdiction including state compliance, statutes and case law  
  • Experience handling AZ, CO, UT and Asbestos cases a plus
  • Strong organizational, prioritization and time management skills
  • Open communication style that fosters continuous learning and team collaboration
  • Written, oral and presentation skills that are effective with a variety of customers
  • Understanding of insurance fundamentals: claims, underwriting, agency relationships, and the business impact of accurate payments, coding and reserves