ESIS Senior Claims Representative, WC

ESIS Senior Claims Representative, Workers’ Compensation (WC) – Tampa, FL

Description

Join ESIS as a Senior Claims Representative in Tampa, FL, specializing in Workers’ Compensation. This role offers a flexible hybrid work schedule—work 3 days in the office and 2 days remotely each week—providing the balance you need to excel professionally and personally.

Key Responsibilities:

🔹 Claims Management: Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with applicable laws, regulations, and company policies. Handle complex and intricate cases requiring an advanced skillset.
🔹 Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear and professional communication throughout the claims process.
🔹 Investigation: Conduct thorough investigations, including gathering statements, reviewing medical records, and analyzing accident reports to determine compensability and liability.
🔹 Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on the facts of the case and applicable laws.
🔹 Documentation: Maintain detailed and organized claim files, documenting all activities, communications, and decisions in the claims management system.
🔹 Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, while ensuring appropriate reserves are established and maintained.
🔹 Compliance: Ensure adherence to state-specific workers' compensation laws, regulations, and reporting requirements.
🔹 Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status.
🔹 Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes.
 

 

 

🔹 Experience: Minimum of 5+ years handling workers' compensation claims; prior experience with ESIS or similar third-party administrators is a plus.
🔹 Knowledge & Licensing: Knowledge of Florida Workers’ Compensation and an active adjuster license, or the ability to obtain licensure within a specified timeframe.
🔹 Skills:
  🔹 Strong analytical and problem-solving abilities
  🔹 Excellent verbal and written communication skills
  🔹 Proficiency in claims management systems and Microsoft Office Suite
  🔹 Ability to manage multiple priorities and meet deadlines in a fast-paced environment
🔹 Knowledge: Familiarity with workers' compensation laws, medical terminology, and claim handling best practices. As a Senior Claim Representative, you will handle more complex and intricate cases requiring advanced skills.

Ready to advance your career with ESIS?
Apply today and be part of a team dedicated to excellence in claims management, with the flexibility of a hybrid work environment.

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, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally.

At Chubb, 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, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.