ESIS Claims Representative, WC
Core
Investigate workers' compensation claims to determine injury extent, establish reserves, and manage cases to resolution while controlling loss costs.
Role type
Senior claims adjuster (workers' compensation)
Builds
Resolved claims and accurate financial reserves for clients and carriers
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
workers' compensation laws and procedures, claim investigation, reserve calculation, benefit payment determination, financial exposure analysis, multi-jurisdictional statutory compliance, vendor and provider management, Microsoft Excel, Microsoft Word
Preferred skills
third-party administrator (TPA) environment experience, AIC designation, CPCU designation
Technologies
Microsoft Word, Microsoft Excel, ESIS claim system
Responsibilities
Adjust claims in accordance with company policies and procedures, independently manage a workers' compensation pending caseload, identify short- and long-term financial exposures and establish accurate reserves, determine, calculate, and issue accurate benefit payments to injured workers, medical providers, and vendors, document claim activity, investigations, and action plans clearly in the ESIS claim system, manage large sums of client or carrier funds accurately and effectively
Seniority
Senior, hands-on IC