ESIS Senior Claims Representative, WC
Core
Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with laws and regulations.
Role type
Senior Claims Representative (Workers' Compensation)
Builds
Claims resolutions and cost control for commercial clients
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
Workers' compensation claims management, claim investigation, decision-making on claim acceptance/denial/settlement, cost control, regulatory compliance, claims management systems proficiency
Preferred skills
Nevada or California workers' compensation experience, third-party administrator (TPA) experience, bachelor's degree, adjuster licensing
Technologies
Claims management systems, Microsoft Office Suite
Responsibilities
Investigate and settle claims promptly, serve as primary contact for injured workers and stakeholders, conduct thorough investigations including reviewing medical records, make decisions on claim acceptance or denial, maintain detailed claim files, monitor and manage claim costs, ensure adherence to state-specific laws
Seniority
Senior, hands-on IC