Senior Claims Examiner

Job Description

Chubb is currently seeking a Workers' Compensation Lost Time Claim Examiner for our Central Region, reporting to either our Dallas, TX or Chicago, IL office.

This position is a hybrid work model role requiring in office attendance three days a week with two days of remote work.

The successful applicant will handle claims in multiple jurisdictions that make up the Central Region office. Jurisdictions handled in the Central Region include, IL, TX, IN, MI, IA, MO, KS, MN, WI, SD, KY, LA, OK, AR, and NE.

Major Duties and Responsibilities :

• Evaluate and determine coverage on incoming workers' compensation claims
• Investigates and determines compensability on lost time workers' compensation claims
• Handles all aspects of workers' compensation lost time claims from set-up to case closure, ensuring strong customer relations are maintained throughout the process
• Timely administration of statutory medical and indemnity benefits
• Sets reserves within authority limits for medical, indemnity, and expense exposure anticipated on lifespan of the claim file
• Manage medical plans for injured workers through internal and external collaboration
• Collaborate with external counsel in bringing litigated claim files to resolution
• Manage return to work plans through collaboration with the insured, external business partners, and the injured worker
• Provide exceptional and timely customer service on all requests from involved parties
• Assure regulatory requirements are met on all claim files including form filings, EDI submissions, file coding, and more
• Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized

Technical Skills & Competencies

• Knowledge of workers' compensation statutes, regulations, and compliance demands
• Ability to incorporate data analytics and modeling into daily activities
• 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 with time management, multi-tasking, and prioritization of work
• Ability to prepare and present to internal and external business partners
• Ownership and self-accountability to meet Chubb quality standards for service
• Superior verbal and written communication skills

Experience, Education, & Requirements

• Experience working in a customer-focused, fast-paced 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 is a plus but not required
• Familiarity with claim handling (healthcare, short-term / long-term disability, auto personal injury protection, medical injury, or general liability) is a plus but not required
• Prior insurance, legal or corporate business experience is a plus but not required
• AIC, RMA, or CPCU-completed coursework or designation(s) is a plus but not required
• Proficiency with Microsoft Office Products
• Knowledge of medical terminology is a plus but not required
• Knowledge of bill processing is a plus but not required
• Applicable workers' compensation licensing will be necessary; however, they are not required at the time of applying for this position
• If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.

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.