Description

JOB DESCRIPTION

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 skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we are dedicated to providing exceptional service and innovative solutions, and we are looking for passionate individuals to be part of our dynamic team. If you are eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

We are seeking a skilled Senior Claims Representative to enhance our team. Reporting to the Claims Team Leader, this role plays a vital part in investigating and managing claims promptly and equitably, in line with established best practices.

Key Responsibilities:

• Conduct thorough investigations by reviewing claims and policy information to assess the extent of the policy's obligation to the insured.
• Contact and interview insured individuals, claimants, witnesses, healthcare providers, attorneys, law enforcement, and other relevant parties to secure necessary claim information.
• Prepare detailed reports on investigations, settlements, claim denials, and evaluations of parties involved.
• Set reserves within authority limits and recommend reserve adjustments to the Team Leader.
• Regularly review claim progress with the Team Leader, identifying challenges and suggesting possible solutions.
• Prepare and present for review any unusual or potentially undesirable exposures to the Team Leader.
• Collaborate on developing improved methods for handling claims and ensuring a timely and equitable settlement process.
• Obtain necessary documentation, including releases, proofs of loss, or compensation agreements, and process claim payments efficiently.

Requisition #: 28626

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