Description

JOB DESCRIPTION

Join ESIS as a Workers' Compensation Claims Representative

Are you ready to make a meaningful impact in the world of workers' compensation? At ESIS, a leader in risk management and insurance services, your skills help create safer workplaces and support employees in times of need. We are committed to exceptional service and innovative solutions-and we're looking for passionate individuals to join our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our workers' compensation opportunities and help us build a brighter future for employees everywhere.

Position Overview:
As a Workers' Compensation Claims Representative, you will begin under direct supervision, performing customer service and claims functions while training to become a fully independent claims representative. You'll gain hands-on and classroom experience, and will be assigned a caseload as your training progresses.

Key Responsibilities:

• Claims Management: Investigate, evaluate, and manage workers' compensation claims from start to finish, ensuring compliance with all laws, regulations, and company policies.
• Communication: Serve as the main contact for injured workers, employers, medical providers, and other stakeholders, delivering clear and professional communication throughout the claims process.
• Investigation: Conduct thorough investigations, gather statements, review medical records, and analyze accident reports to determine compensability and liability.
• Decision-Making: Make timely, accurate decisions regarding claim acceptance, denial, or settlement based on case facts and applicable laws.
• Documentation: Maintain organized claim files, documenting all activities, communications, and decisions.
• Cost Control: Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, ensuring appropriate reserves.
• Compliance: Adhere to state-specific workers' compensation laws, regulations, and reporting requirements.
• Customer Service: Provide exceptional service to clients by addressing inquiries, resolving issues, and delivering timely updates.
• Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal outcomes.

Requisition #: 27424

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