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ESIS Claims Representative in Alpharetta, GA at Chubb Group of Insurance Companies

Date Posted: 4/21/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    4300 North Point Parkway
    Alpharetta, GA
  • Job Type:
    Insurance
  • Experience:
    2 to 5 years
  • Date Posted:
    4/21/2018

Job Description

The Claim Representative:  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 assignments.
  • Reviews claim information to provide background for investigation.
  • Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, etc. to secure necessary claim information.
  • Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company’s obligation to the insured under the policy contract.
  • Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
  • Sets reserves within authority limits and recommends reserve changes to Team Leader.
  • Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.
  • Prepares and submits to Team Leader unusual or possible undesirable exposures. Assists Team Leader in developing methods and improvements for handling claims.
  • Settles claims promptly and equitably.
  • Informs claimants, insureds/customers or attorney of denial of claim when applicable.
  • May assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements. Continues efforts to settle claims before trial.
  • Refers claims to subrogation as appropriate. May arrange for salvage disposition or other recovery proceedings as necessary by line of business.
  • May participate in claim file reviews and audits with customer/insured and broker. Administers benefits timely and appropriately. Maintains control of claim’s resolution process to minimize current exposure and future risks
  • Establishes and maintains strong customer relations
  • Investigate compensability and benefit entitlement
  • Review and approve medical bill payments
  • Manage vocational rehabilitation as applicable

DESIRED QUALIFICATIONS:

  • College degree or 2-5 years’ experience handling workers' compensation claims
  • Basic knowledge of claims handling and familiarity with claims terminologies
  • Effective negotiation skills
  • Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses.
  • Ability to self-motivate and work independently
  • Knowledge of company products, services, coverage’s and policy limits, along with awareness of the company’s claims best practices
  • Knowledge of applicable state and local laws

ESIS offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, a generous retirement savings plan, disability coverage, stock purchase plan, flexible spending accounts, tuition reimbursement, and business casual dress. At ESIS, 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, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.