Workers' Compensation Senior Lost Time Claim Examiner

Responsibilities

• Independently handle all aspects of workers’ compensation lost time claims from setup to closure for the Northeast, New York, and New Jersey regions.
• Conduct thorough investigations by obtaining facts and taking statements from insureds, claimants, and medical providers.
• Evaluate claim facts to determine compensability and inform relevant parties of claim denials when applicable.
• Manage statutory medical and indemnity benefits and set appropriate reserves within authority limits.
• Work closely with attorneys to manage hearings and litigation.
• Direct vendors, nurse case managers, and rehabilitation managers on medical management and return-to-work initiatives.
• Refer appropriate claims to subrogation to maximize recovery opportunities.
• Ensure compliance with state statutory regulations by filing necessary workers’ compensation forms and electronic data.

Requirements

• 4+ years of direct experience handling workers’ compensation lost time claims.
• Proven experience with litigation management, subrogation, and fraud investigations.
• Experience with medical case management and a strong knowledge of medical terminology.
• Valid claim adjuster licenses for Connecticut (all casualty lines), New Hampshire (workers’ compensation), Rhode Island (workers’ compensation), and Vermont (workers’ compensation).
• Proficiency with Microsoft Office products.
• Strong analytical skills for reserve analysis and financial acumen.

Preferred Qualifications

• Completion of AIC, RMA, or CPCU coursework or designations.

About the Company

Chubb is a world leader in insurance. 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, and exceptional claims handling expertise.