ESIS Senior Claims Representative, WC
Core
Investigate and settle workers' compensation claims promptly and equitably under the direction of a Claims Team Leader.
Role type
Senior IC claims representative (workers' compensation)
Builds
Claim resolutions, settlements, and reserve recommendations for insureds and claimants
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
Workers' Compensation claims handling, policy obligation analysis, claim investigation, liability evaluation, reserve setting, litigation file management, benefits administration, subrogation referral, customer relations
Preferred skills
Associate in Claims (AIC), Associate in Risk Management (ARM), AICPCU, MBA, team-building theory, program evaluation
Technologies
Claims handling systems, risk management systems
Responsibilities
Review claim and policy information to determine policy obligations; Contact and interview insureds, claimants, witnesses, physicians, attorneys, and police to secure claim information; Evaluate facts to determine liability and company obligation; Prepare reports on investigations, settlements, and denials; Set reserves within authority limits; Manage litigation files and arrange witness attendance; Obtain releases and issue payment drafts; Administer benefits and manage vocational rehabilitation; Participate in claim file reviews and audits.
Seniority
Senior, hands-on IC