Description

JOB DESCRIPTION

ESIS Claims Representative - Workers' Compensation
Location: Tampa, FL
Work Schedule: Hybrid (3 days in office / 2 days remote)

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your unique skills and talents help create safer workplaces and support individuals during times of need. At ESIS, we are committed to providing exceptional service and innovative solutions, and we welcome passionate people from all backgrounds to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity, growth, and belonging, explore our exciting workers' compensation roles and discover how you can contribute to a brighter future for everyone.

Position Overview:
Under direct supervision initially, you will perform customer service and claims functions while training to become a claims representative. You'll gain exposure to all facets of the role through classroom and hands-on learning, and will be assigned a caseload as training progresses.

Key Responsibilities:

• Claims Management: Investigate, evaluate, and manage workers' compensation claims from start to resolution, ensuring compliance with all relevant laws, regulations, and company policies.
• Communication: Serve as the primary point of contact for injured workers, employers, medical providers, and other stakeholders, providing clear, respectful, and professional communication throughout the claims process.
• Investigation: Conduct thorough investigations of claims, 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 each 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 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.

Requisition #: 27377

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