ESIS Claims Representative, WC
Core
Investigate, evaluate, and manage workers' compensation claims from inception to resolution, ensuring compliance with laws and managing claim costs.
Role type
Junior to mid-level workers' compensation claims representative
Builds
Resolved claims and accurate benefit payments for injured workers, employers, and medical providers
Domain
Insurance / Workers' Compensation
Required skills
Workers' compensation claims investigation, Claims adjustment, State-specific WC law knowledge (VA, WVA, IN, MI, OH, NC, SC, TN, KY), Benefit calculation, Claim file documentation, Cost monitoring, Compliance reporting
Preferred skills
Third-party administrator (TPA) experience, AIC/CPCU certification, Independent work, Time management
Technologies
Microsoft Word, Microsoft Excel
Responsibilities
Investigate claims and gather statements, Review medical records and accident reports, Make decisions on claim acceptance/denial/settlement, Maintain detailed claim files, Monitor and manage claim costs, Ensure adherence to state WC laws
Seniority
Entry-level to Junior, training-focused