Health Claims Handler - Insurance

Claims Representative

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. We are seeking a Claims Representative to enhance our team. This role plays a vital part in investigating and managing claims promptly and equitably, in line with established best practices.

This is a hybrid position, with three days per week in-office.

Under the direction of the Claims Team Leader, the ESIS California Claim Representative investigates and resolves claims promptly, equitably, and in accordance with established best practice guidelines.

Claims Management: Investigate, evaluate, and manage workers' compensation claims from initiation to resolution, ensuring compliance with relevant laws, regulations, and company policies.

Communication: Act as the primary contact for injured workers, employers, medical providers, and other stakeholders, delivering clear and professional communication throughout the claims process.

Conduct thorough investigations, including collecting statements, reviewing medical records, and analyzing accident reports to determine compensability and liability.

Decision-Making: Make timely and accurate decisions regarding claim acceptance, denial, or settlement based on case facts and applicable laws.

Maintain organized and detailed claim files, documenting all activities, communications, and decisions within the claims management system.

Monitor and manage claim costs, including medical expenses, indemnity payments, and legal fees, ensuring appropriate reserves are established and maintained.

Customer Service: Provide high-quality service to clients by addressing inquiries, resolving issues, and delivering timely updates on claim status.

Collaboration: Work closely with internal teams, including legal, medical, and risk management professionals, to achieve optimal claim outcomes.

An applicable resident or designated home state adjuster's license is required for ESIS Field Claims Adjusters. Adjusters that do not fulfill the license requirements will not meet ESIS's employment requirements for handling claims. ESIS supports independent self-study time and will allow up to 4 months to pass the adjuster licensing exam. Chubb offers a comprehensive benefits package, more details on which can be found on our careers website.

Chubb is a world leader in insurance. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance, and life insurance to a diverse group of clients. The company is distinguished by its extensive product and service offerings, broad distribution capabilities, exceptional financial strength, underwriting excellence, superior claims handling expertise and local operations globally. At Chubb, we are committed to equal employment opportunity and compliance with all laws and regulations pertaining to it. Our policy is to provide employment, training, compensation, promotion, and other conditions or opportunities of employment, without regard to race, color, religious creed, sex, gender, gender identity, gender expression, sexual orientation, marital status, national origin, ancestry, mental and physical disability, medical condition, genetic information, military and veteran status, age, and pregnancy or any other characteristic protected by law. Performance and qualifications are the only basis upon which we hire, assign, promote, compensate, develop and retain employees.