ESIS Senior Claims Specialist, WC

Job description

Under the direction of the Claims Team Leader, the Claims Representative investigates and resolves claims promptly, equitably, and in accordance with established best practices. Major Duties & Responsibilities: Duties may include, but are not limited to: - Receive and review new claim assignments. - Analyze claim and policy information to provide background for investigations and determine the extent of policy obligations. - Contact, interview, and obtain statements (recorded or in person) from insureds, claimants, witnesses, physicians, attorneys, police officers, and other relevant parties to gather necessary claim information. - Arrange for surveys and engage experts as appropriate. - Evaluate facts obtained during investigations to determine liability and the company’s obligations under the policy contract. - Prepare reports on investigations, settlements, denials, and evaluations of involved parties. - Set reserves within authority limits and recommend reserve changes to the Team Leader as needed. - Review claim progress and status with the Team Leader, discussing challenges and recommending solutions. - Manage litigation files in a timely and appropriate manner. - Assist the...