ESIS recognizes each risk management program is unique, and we are committed to providing consultative and innovative solutions to drive superior results. Our culture and vision enables us to effectively operate as an extension of our clients’ risk management program, aligning combined goals to form a collaborative partnership.
We recognize our clients’ desire to do things differently, and we are confident that our integrated approach will deliver better overall results. ESIS’ specialized claim intervention strategy integrates an effective deployment of resources and appropriate actions, which are essential to our success
ESIS, Inc. (ESIS) provides sophisticated risk management services designed to reduce claims frequency and loss costs. ESIS, the Risk Management Services Company of Chubb, provides claims, risk control & loss information systems to Fortune 1000 accounts. ESIS employs more than 1,500 professionals in nine regional centers and 15 major claims offices, as well as local representatives in select jurisdictions. We take our fiduciary responsibilities seriously and are proud to manage over $2.5 billion of customer losses and over 320,000 new claims annually. We specialize in large accounts which have multi-state operations. For information regarding ESIS please visit www.esis.com.
ESIS is seeking an experienced Accident and Health (A&H) Claims representative for the Southfield, MI office. The person in this role will handle and maintain all A&H claims and file reviews under general supervision of a supervisor and as part of the ESIS team.
Under the direction of the Claims Team Leader investigates and settles claims promptly, equitably and within established best practices guidelines.
MAJOR DUTIES & RESPONSIBILITIES:
Duties include but are not limited to:
- 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 claimants, insureds/customers or attorney of denial of claim when applicable.
High level of technical claims knowledge and competence as evidenced by a minimum of 2 years claims handling experience in specific line of business (A&H). Experience within a TPA environment strongly preferred. Required to obtain specific state licenses.
Knowledge of coverages; along with a good understanding of applicable legal principles.
Excellent communication, negotiation and interpersonal skills to effectively interact with all levels of an organization both internal and external.
Strong analytical and problem solving ability.
Demonstrated ability to provide consistent superior service to customers.
Chubb offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, a generous retirement savings plan, disability coverage, stock purchase plan, flexible spending accounts, tuition reimbursement, and business casual dress. 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, religion, age, sex, sexual orientation, transgender, national origin, disability, genetic information, veteran or marital status, or any other characteristic protected by law.
For additional information about Chubb or its services, please visit our website at http://www.chubb.com.
In order to be considered an applicant for employment with Chubb, all applicants must go to Chubb’s Careers website www.chubb.com/careers to apply for the position(s) of interest and complete an online application. If you do not complete the online application, you will not be considered an applicant in accordance with Chubb’s policy.