Workers' Senior Claim Representative

* Description
* Chubb max bill rate: 65.59 - 72.88
Supplier bill rate:
Job schedule-40 hours on site
Job hours-8:00-4:30
Interview process-WEBEX prescreen/Then in-person interview

Job Description:

CHUBB is currently seeking a Workers Compensation Lost Time Claim Examiner for our West Coast/Pacific region. The successful applicant will be handling claims from California. The position will report and reside in our Los Angeles CA
Duties Responsibilities:
- Handles all aspects of workers compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
- Reviews claim and policy information to provide for investigation.
- Conducts 3-part ongoing investigations obtaining facts and taking statements as necessary with insured claimant and medical providers.
- Evaluates the facts gathered through the investigation to determine compensability of the claim.
- Informs insureds claimants and attorneys of claim denials when applicable.
- Prepares reports on investigation settlements denials of claims and evaluations of involved parties etc.
- Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
- Sets reserves within authority limits for medical indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim.
- Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
- Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
- Works with attorneys to manage hearings and litigation
- Controls and directs vendors nurse case managers telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.
- Complies with customer service requests including Special Claims Handling procedures file status notes and claim reviews.
- Files workers compensation forms and electronic data with states to ensure compliance with statutory regulations.
- Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
- Works with in-house Technical Assistants Special Investigators Nurse
- Consultants Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.
- Technical Skills

Competencies:

- Lost Time Claim Examiner position with prior experience in workers compensation as a lost time examiner.
- Requires basic knowledge of workers compensation statutes regulations and compliance.
- Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues.
- Exceptional customer service and focus.
- Ability to openly collaborate with leadership and peers to accomplish goals.
- Demonstrates a commitment to a career in claims.
- Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines.
- Use analytical skills to find mutually beneficial solutions to claim and customer issues.
- Ability to prepare and make exceptional presentations to internal and external customers.
- Conscientious about the quality and professionalism of work product and relationships with co-workers and clients.
- Willing to take ownership and tackle obstacles to meet Chubb's quality standards for service investigation reserving inventory management teamwork and diversity appreciation.
- Superior verbal and written communication skills.

Experience

Education Requirements:

- Experience working in a customer focused fast-paced fluid environment
- Experience utilizing strong communication and telephonic skills
- Prior experience requiring a high level of organization follow-up and accountability
- Prior workers compensation claim handling experience or other similar type of claim handling experience is required healthcare short-term / long-term disability auto personal injury protection / medical injury or general liability.
- Prior insurance legal or corporate business experience is a plus but not required
- AIC RMA or CPCU completed…