Sr. Claims Examiner at Chubb

Posted in General Business 23 days ago.

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Type: Full-Time
Location: Jersey City, New Jersey





Job Description:

Chubb is the world’s largest publicly
traded property and casualty insurer. 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. 

 

Currently we are seeking a Workers' Compensation Lost Time Senior Claim
Examiner the Northeastern Claim Region working in Jersey City, New Jersey or New Haven, Connecticut.


The Senior Claim Examiner will be responsible for the direct handling of lost
time workers’ compensation claims in Connecticut, Massachusetts, Rhode Island,
New Hampshire, Vermont, Maine, New York and New Jersey.  The Senior Examiner
investigates and settles claims promptly, equitably and within established best
practices and statutory compliance guidelines.

 

Duties
may include but are not limited to:



  • Receive assignments


  • 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


  • 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


  • 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 and timely issues
    indemnity benefits if due and owing   


  • Informs claimants,
    insureds/customers or attorney of denial of claim when applicable


  • Preparing cases for trial/board
    hearing by taking statements and continues efforts to settle claims before
    and during trial / board hearing


  • Investigates and refers claims
    to subrogation as appropriate.


  • May participate in claim file
    reviews and audits with customer/insured and broker. Administers Workers’
    Compensation benefits timely and appropriately per Jurisdiction. Maintains
    control of claim’s resolution process to minimize current exposure and
    future risks


  • Establishes and maintains strong
    customer relations



Other
duties may include:



  • Working all queues, tasks and
    diary in a timely manner


  • Investigating compensability and
    benefit entitlement


  • Reviewing and approving medical
    bill payments


  • Managing vocational
    rehabilitation

Competencies/Technical Skills:


  • A personal commitment to superior performance that adds value to our company

  • Knowledge of claims handling

  • Familiarity with claim and medical terminology

  • Effective negotiation skills

  • An ability to work effectively with a wide variety of people

  • Excellent organizational skills

  • Ability to multi-task with proven time management skills

  • Ability to work well in teams

  • Demonstrated critical thinking and decision making ability

  • Excellent verbal and written communication skills


Education:


  • Adjuster license(s) to handle Workers Compensation claims is required and/or must be obtained immediately after hire date – Connecticut, Rhode Island, New Hampshire and Vermont

  • Bachelor’s Degree or equivalent experience

  • Minimum of 3 years of Workers Compensation claim handling experience; specific venue knowledge a plus





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