Senior Claims Representative, WC

Responsibilities

• Investigate and settle workers' compensation claims promptly and equitably following established best practices.
• Review claim and policy information to determine the extent of the company's obligation to the insured.
• Conduct interviews and obtain statements from claimants, witnesses, physicians, attorneys, and police officers.
• Evaluate facts to determine liability and prepare detailed reports on investigations, settlements, and denials.
• Set reserves within authority limits and recommend necessary changes to the Team Leader.
• Manage claim resolution processes to minimize current exposure and future risks.
• Administer workers' compensation benefits timely and appropriately according to jurisdiction.
• Maintain strong customer relations with claimants, insureds, brokers, and attorneys.

Requirements

• 3-5 years of experience handling Workers' Compensation claims.
• Valid resident or designated home state adjuster's license (required).
• Strong knowledge of claims handling procedures and industry terminology.
• Effective negotiation and interpersonal skills for communicating with diverse stakeholders.
• Proven ability to work independently with strong organization and time management skills.
• Comprehensive knowledge of applicable state and local laws.

Preferred Qualifications

• Experience working within specific jurisdictions including MD, DC, VA, NC, SC, TN, KY, WVA, OH, IN, or MI.

About the Company

ESIS, a multi-line Third-Party Administrator (TPA) under the Chubb umbrella, provides sophisticated risk management services to Fortune 1000 clients. We specialize in workers' compensation claims handling, casualty insurance products, and disability management, helping to create safer workplaces through exceptional service and innovative solutions.