Description

JOB DESCRIPTION

Are you ready to make a meaningful impact in the field of workers' compensation? Join ESIS, a leader in risk management and insurance services, where your expertise helps create safer workplaces and supports employees during critical moments. At ESIS, we are committed to delivering exceptional service and innovative solutions. We seek dedicated professionals to join our dynamic team. If you are motivated to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation opportunities and help shape a brighter future for employees everywhere.

Position Overview:
The Senior Claims Representative, reporting to the Claims Team Leader, plays a crucial role in investigating and managing claims efficiently and fairly, in accordance with established best practices.

While this position is fully remote, the individual must reside in Alaska.

Key Responsibilities:

• Conduct thorough investigations by reviewing claims and policy information to assess the extent of the policy's obligation to the insured.
• Contact and interview insured individuals, claimants, witnesses, healthcare providers, attorneys, law enforcement, and other relevant parties to obtain necessary claim information.
• Evaluate facts from investigations to determine liability and the company's obligation under the policy contract.
• Prepare comprehensive reports on investigations, settlements, claim denials, and evaluations of involved parties.
• Set reserves within authority limits and recommend adjustments to the Team Leader as needed.
• Regularly review claim progress with the Team Leader, identify challenges, and propose solutions.
• Present unusual or potentially undesirable exposures to the Team Leader for review.
• Collaborate with the team to develop improved methods for handling claims and ensuring timely, equitable settlements.
• Obtain required documentation, such as releases, proofs of loss, or compensation agreements, and process claim payments efficiently.
• Communicate claim decisions, including denials, to claimants, insureds, customers, or attorneys as appropriate.

Requisition #: 31122

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