ESIS Work Comp Claims Rep Job in Chatsworth, California US
ACE Group
The ACE Group of Companies is one of the worlds leading global commercial
property and casualty insurance and reinsurance organizations, with 16,000
employees worldwide and offices in more than 50 countries.
ACE serves the property and casualty insurance needs of businesses of all
sizes in a broad range of industries. We also provide specialized insurance
products—such as personal accident, supplemental health and life insurance—to
individuals in select countries. Our reinsurance operations include both
property and casualty and life companies.
Details of this critical opening follow:
ESIS Workers' Compensation Claims Rep
KEY OBJECTIVE:
Under the direction of the Claims Team Leader investigates and settles claims promptly, equitably and within established best practices guidelines.
MAJOR DUTIES RESPONSIBILITIES:
Under limited supervision, Receives assignments and 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.
Depending on line of business may inspect and appraise damage for property losses or arranges for such appraisal.
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, proofs of loss or compensation agreements and issues company drafts in payments for claims. Informs claimaints, insureds/customers or attorney of denial of claim when applicable.
May assist Team Leader and company attorneys in preparing cases for trial by arranging for attendance of witnesses and taking statements. Continues efforts to settle claims before trial.
Refers claims to subrogation as appropriate. May arrange for salvage disposition or other recovery proceedings as necessary by line of business.
May participate in claim file reviews and audits with customer/insured and broker.
Administers benefits timely and appropriately. Maintains control of claim’s resolution process to minimize current exposure and future risks
Establishes and maintains strong customer relations
May be responsible for providing training and guidance to less experienced claims representatives.
Depending on line of business, other duties may include:
Maintaining system logs
Investigating compensability and benefit entitlement
Reviewing and approving medical bill payments
Managing vocational rehabilitation
DESIRED QUALIFICATIONS:
8 or more years experience handling claims in a relevant line of business as evidenced by career progression within ACE or similar organization.
Ability to work indedpendently with limited direction from a Team Leader.
Authoritative technical knowledge of claims handling and claims terminologies
Superior 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.
Strong knowledge of ACE products, services, coverages and policy limits, along with a solid understanding of ACE claims best practices
Commanding knowledge of applicable state and local laws related to line of business handled.
Superior customer service skills.
ACE offers a competitive salary plus cash bonus, equity opportunities and a
comprehensive benefits package including life, health, dental, vision, a
generous retirement savings plan with a generous company match, disability
coverage, stock purchase plan, flexible spending accounts, tuition
reimbursement, and business casual dress.
Sound like the right job for you? For consideration, please apply below.
If you would like additional information about the ACE Group, please visit our
website at http://www.acelimited.com