JOB DESCRIPTION

Are you ready to make a meaningful impact in the world of workers' compensation? 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. At ESIS, we're dedicated to providing exceptional service and innovative solutions, and we're looking for passionate individuals to be part of our dynamic team. If you're eager to advance your career in a collaborative environment that values integrity and growth, explore our exciting workers' compensation roles today and discover how you can contribute to a brighter future for employees everywhere!

ESIS is looking to hire a Workers' Compensation Team Leader to supervise and direct the activities of Claims Representatives, Specialists, Claims Assistants, and/or other clerical support positions in the investigation and management of workers' compensation claims to ensure prompt, efficient, and fair claims handling. Ensure a high level of customer service and claim file quality.

GENERAL RESPONSIBILITIES:

• Improve the technical quality of files within the team.
• Act as a team facilitator to help remove barriers and take an active role in resolving team issues.
• Be an integral member of the Claims Office Workers' Compensation Management Team.
• Be responsible for ongoing team development, ensuring effective loss dollar management, and providing value-added customer service.
• Maintain a strong commitment to team building and ESIS management principles.
• Understand and utilize current information systems.
• Collect and analyze data to identify individual opportunities for improvement.
• Work with individuals to assess their knowledge and skill gaps and develop plans for enhancement.
• Promote ESIS Claims Management Division strategies and values.
• Address Human Resource issues and problems effectively.
• Demonstrate a proactive approach to servicing external and internal customers.
• Show understanding and ability to apply the technical aspects of claims handling.
• Provide one-on-one coaching and counseling to team members.
• Effectively evaluate programs and procedures for continuous improvement.

SPECIFIC RESPONSIBILITIES:

• Review and assign all new claims based on customer needs and claim complexity.
• Determine initial reserves and provide direction to representatives as needed, identifying issues with compensability, medical conditions, subrogation, etc.
• Ensure that all coding and documentation are appropriate.
• Follow files according to diaries established by the system as well as individual claim file diaries based on the complexity of the file or customer agreements.
• Review files at key checkpoints for investigation, medical management, subrogation, statutory requirements (forms, etc.), reserve accuracy, fraud indicators, and provide guidance on ESIS best practices as well as account and carrier requirements.
• Participate in account discussions regarding file issues if they escalate beyond the representative.
• Review status reports for accounts as needed and participate in file reviews as required.
• Manage overall performance for team members, including attendance, file quality, service, and interpersonal issues.
• Ensure reserve adequacy in compliance with ESIS and carrier requirements.
• Participate in litigation strategy sessions.
• Review and correct a variety of internal documents (reserves, appeals, internal audit requirements, SAS 70, etc.), sometimes completing them personally.
• Participate in the strategy and management of catastrophic injuries, collaborating with accounts, nurses, representatives, claims vice presidents, the home office, carriers, etc.
• Conduct quality audits in addition to individual claim file reviews.
• Provide feedback and responses to carrier, customer, and broker reviews.
• Coordinate training for the team and often for the office on jurisdictional, medical, procedural, carrier requirement, and account requirement topics.
• Resolve concerns from customers, claimants, brokers, or carriers if they escalate beyond the representative.
• Balance caseloads of representatives within the team and across the office.
• Train new hires in all aspects of claims handling.
• Manage the closing of cases to ensure they move quickly and accurately.

MINIMUM REQUIREMENTS:

• A four-year college degree and/or equivalent work experience or additional degrees (e.g., MBA).
• A high level of technical claims knowledge and competence in Workers' Compensation claims, demonstrated by at least 5 years of claims handling experience at ESIS or within a similar organization.
• Thorough knowledge of Workers' Compensation products, services, and coverages, along with a solid understanding of applicable legal principles.
• Knowledge of Workers' Compensation cost containment programs and proven account management skills are essential.
• Relevant insurance designations such as Associate in Claims (AIC), Associate in Risk Management (ARM), AICPCU, etc.
• Ability to plan, organize, and implement general business and people management practices, evidenced by successful completion of Management and Technical Programs, business or legal college-level curriculum, or equivalent practical work experience.
• Demonstrated effective communication and interpersonal skills to interact with subordinates and all levels of ESIS personnel, as well as attorneys, producers, and accounts.
• A solid understanding of team-building theory and its application to ongoing and planned activities.
• Ability to evaluate the effectiveness of various programs and procedures and incorporate improvements. Ability to facilitate and lead groups of people.
• Demonstrated evaluative thinking by seeking out and considering multiple sources of data to form conclusions and determine courses of action.
• Evidence of strengthening personal effectiveness by demonstrating confidence, credibility, and commitment to established strategies and values.
• Demonstrated creativity and self-motivation in current position and activities through direct claims handling and other related functions.
• Evidence of the ability to manage activities and resource allocation issues, ensuring timely, high-quality service and longer-term payback opportunities related to claims handling processes.

QUALIFICATIONS

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  ABOUT US
  
  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. Chubb prohibits all unlawful discrimination, harassment and retaliation against any individual who reports discrimination or harassment.