Description

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  Requires minimal oversight to independently handle all aspects of workers' compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process
  
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  Reviews claim and policy information to provide background for investigation
  
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  Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers
  
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  Evaluates the facts gathered through the investigation to determine compensability of the claim
  
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  Informs insureds, claimants and attorneys of claim denials when applicable
  
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  Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
  
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  Timely administration of statutory medical and indemnity benefits throughout the life of the claim
  
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  Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to the Leadership Team throughout the life of the claim
  
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  Reviews the claim status at regular intervals and makes recommendations to the Leadership Team to discuss problems and remedial actions to resolve them
  
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  Prepares and submits to Leadership Team unusual or possible undesirable exposures when encountered
  
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  Works with attorneys to manage hearings and litigation
  
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  Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives
  
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  Complies with customer service requests including Special Claims Handling procedures, file status notes, and claim reviews
  
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  Files workers' compensation forms and electronic data with states to ensure compliance with statutory regulations
  
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  Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized
  
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  Works with in-house Technical Assistants, Special Investigators, Nurse
  Consultants, Telephonic Case Managers as well as the Leadership Team to exceed customer's expectations for exceptional claims handling service
  

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  Understands day-to-day responsibilities of a Lost Time Claim Examiner in managing all aspects of workers' compensation claims
  
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  Works with a high degree of autonomy and showcases venue expertise
  
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  Serves as a mentor and informal leader to staff with less seniority
  
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  Utilizes influence management skills to drive results, consistency amongst peers and as motivation
  
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  Provides project management
  
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  Serves as a subject matter expert
  
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  Requires knowledge of workers' compensation statutes, regulations, and compliance
  
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  Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues
  
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  Exceptional customer service and focus
  
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  Ability to openly collaborate with leadership and peers to accomplish goals
  
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  Demonstrates a commitment to a career in claims
  
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  Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines
  
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  Use analytical skills to find mutually beneficial solutions to claim and customer issues
  
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  Ability to prepare and make exceptional presentations to internal and external customers
  
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  Conscientious about the quality and professionalism of work product and
  relationships with co-workers and clients
  
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  Willing to take ownership and tackle obstacles to meet Chubb's quality
  standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation
  
• Superior verbal and written communication skills

• 4+ years of direct handling claims for workers' compensation lost time claims
• Experience working in a customer focused, fast-paced, fluid environment
• Experience utilizing strong communication and telephonic skills
• Prior experience demonstrating a high level of organization, follow-up and accountability
• AIC, RMA, or CPCU completed coursework or designation(s) is a plus but not required
• Experience with litigation management
• Experience with subrogation investigations
• Experience with fraud investigations
• Experience with medical case management
• Knowledge of medical terminology
• Conduct reserve analyses to ensure adequacy and demonstrate financial acume m
• Proficiency with Microsoft Office Products
• If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.