Description

JOB DESCRIPTION

Are you ready to make a meaningful impact in the world of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your skills and talents can help us create safer workplaces and support employees during their times of need. At ESIS, we are dedicated to providing exceptional service and innovative solutions, and we are looking for passionate individuals to be part of our dynamic team. If you are eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

We are seeking a Claims Associate to join our team, responsible for managing the workers' compensation claims desk. This role offers hands-on business experience and interactive instruction to support the development of a successful workers' compensation claims professional. Candidates with a Bachelor's degree, Master's degree, or equivalent experience are encouraged to apply. This is an excellent opportunity to join a growing, financially stable, and successful company. As an industry leader, we offer a dynamic and inclusive environment for individuals looking to build a meaningful career in a fast-paced setting, with offices in many major U.S. cities.

Major Duties & Responsibilities

• Receive assignments and review claim and policy information to provide background for investigation and determine the extent of the policy's obligation to the insured, depending on the line of business, under close supervision.
• Contact, interview, and obtain statements (recorded or in person) from insured parties, claimants, witnesses, physicians, attorneys, police officers, and others to secure necessary claim information.
• Evaluate facts gathered during investigations to determine the extent of liability and the company's obligation under the policy contract.
• Prepare reports on investigations, settlements, claim denials, and evaluations of involved parties.
• Set reserves within authority limits and recommend reserve changes to the Team Leader.
• Review progress and status of claims with the Team Leader and discuss challenges and recommended solutions.
• Prepare and submit to the Team Leader any unusual or potentially undesirable exposures.
• Assist the Team Leader in developing methods and improvements for handling claims.
• Settle claims promptly and equitably.
• Obtain releases, proofs of loss, or compensation agreements and issue company drafts for claim payments.
• Communicate claim denials to claimants, insured parties, or attorneys as appropriate.
• Assist the Team Leader and company attorneys in preparing cases for trial, including arranging witness attendance and taking statements. Continue efforts to settle claims prior to trial.
• Participate in claim file reviews and audits with customers, insured parties, and brokers.
• Administer benefits in a timely and appropriate manner. Maintain control of the claims resolution process to minimize current exposure and future risks.

Requisition #: 30105

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