ESIS Professional Associate – Claims at ACE Limited

Expires in 13 days


 
Job Description - ESIS Professional Associate – Claims (323189)
Job Description


ESIS Professional Associate – Claims(

Job Number:

323189)

Description
The Workers’ Compensation Claim Representative, under the direction of the Claims Team Leader, investigates and settles claims promptly, equitably and within established best practices guidelines.
MAJOR DUTIES & RESPONSIBILITIES:
Duties may include but are not limited to:
  • Receive assignments.
  • Reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business.
  • Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
  • Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company’s obligation to the insured under the policy contract.
  • Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
  • Sets reserves within authority limits and recommends reserve changes to Team Leader.
  • Reviews progress and status of claims with Team Leader and discusses problems and suggested remedial actions.
  • Prepares and submits to Team Leader unusual or possible undesirable exposures. Assists Team Leader in developing methods and improvements for handling claims.
  • Settles claims promptly and equitably.
  • Obtains releases and timely issues indemnity benefits if due and owing.
  • Informs claimants, insureds/customers or attorney of denial of claim when applicable.
  • May assist Team Leader and company attorneys in preparing cases for trial by taking statements. Continues efforts to settle claims before trial.
  • Refers claims to subrogation as appropriate.
  • May participate in claim file reviews and audits with customer/insured and broker. Administers Workers’ Compensation benefits timely and appropriately per Jurisdiction. Maintains control of claim’s resolution process to minimize current exposure and future risks
  • Establishes and maintains strong customer relations

Other duties may include:
  • Working all queues and diary in a timely manner
  • Investigating compensability and benefit entitlement
  • Reviewing and approving medical bill payments
  • Managing vocational rehabilitation


Qualifications
DESIRED QUALIFICATIONS:
  • Recent college graduate or 2-5 years’ experience handling Workers’ Compensation claims
  • Knowledge of claims handling and familiarity with claims terminologies
  • Effective negotiation skills
  • Strong communication and interpersonal skills to be capable of dealing with claimants, customers, insureds, brokers, attorneys etc. in a positive manner concerning losses.
  • Ability to self-motivate and work independently, excels in organization and time management skills
  • Knowledge of company products, services, coverage’s and policy limits, along with awareness of the company’s claims best practices and client service instructions
  • Knowledge of applicable state and local laws

Tampa - 5100 W Lemon Street
Tampa336091021
Claims

Travel

  • Yes, 25 % of the Time

Job Posting

  • Nov 7, 2018, 7:14:55 PM

 
Apply now

Remember to mention that you found this position via Graduateland