Description

• 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
• Reviews claim and policy information to provide background for investigation
• Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers
• Evaluates the facts gathered through the investigation to determine compensability of the claim
• Informs insureds, claimants and attorneys of claim denials when applicable
• Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
• Timely administration of statutory medical and indemnity benefits throughout the life of the claim
• Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to the Leadership Team throughout the life of the claim
• Reviews the claim status at regular intervals and makes recommendations to the Leadership Team to discuss problems and remedial actions to resolve them
• Prepares and submits to Leadership Team unusual or possible undesirable exposures when encountered
• Works with attorneys to manage hearings and litigation
• Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives
• Complies with customer service requests including Special Claims Handling procedures, file status notes, and claim reviews
• Files workers' compensation forms and electronic data with states to ensure compliance with statutory regulations
• Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized
• 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

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