ESIS ProClaim Representative, A&H

Responsibilities

• Manage an inventory of travel, hospital indemnity, and accidental death and dismemberment claims.
• Review medical and travel documentation to investigate losses and determine coverage obligations.
• Interpret policy language to make accurate coverage and payment determinations.
• Set and evaluate reserves within authorized limits and recommend changes to the Team Leader.
• Contact and interview insureds, claimants, physicians, and other relevant parties to gather information.
• Prepare detailed reports regarding investigations, settlements, and claim denials.
• Maintain accurate claim notes, documentation, and complete file records.
• Communicate claim outcomes professionally to customers, insureds, and attorneys.
• Identify potential fraud indicators and escalate suspicious claims as appropriate.

Requirements

• Proficiency with Microsoft Office applications, including Excel, Word, and PowerPoint.
• Strong written communication skills for documenting policy interpretations and reports.
• Excellent customer service and interpersonal skills.
• Strong time management skills and the ability to prioritize tasks in a fast-paced environment.
• Experience using claims handling systems.

Preferred Qualifications

• Previous experience in claims handling.
• Possession of an active adjuster license.

About the Company

Chubb is a world leader in insurance, providing commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients globally. ESIS, a Chubb company, provides specialized claim and risk management services to a wide variety of commercial clients.