Senior Claim Examiner
Posted 2025-03-15About the position
Chubb is seeking a Senior Claim Examiner specializing in Workers' Compensation Lost Time claims for the Central Region, with a hybrid work model requiring in-office attendance three days a week. The role involves managing claims across multiple jurisdictions, ensuring compliance with regulations, and maintaining strong customer relations throughout the claims process. The successful candidate will independently handle all aspects of claims from setup to closure, conduct investigations, evaluate claims, and collaborate with various stakeholders to ensure effective claims management.
Responsibilities
? Independently handle all aspects of workers' compensation lost time claims from setup to case closure.
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? Conduct ongoing investigations, obtaining facts and taking statements from insured, claimants, and medical providers.
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? Evaluate facts gathered to determine the compensability of claims.
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? Inform insureds, claimants, and attorneys of claim denials when applicable.
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? Prepare reports on investigations, settlements, and evaluations of involved parties.
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? Administer statutory medical and indemnity benefits throughout the life of the claim.
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? Set reserves within authority limits and recommend changes to Team Leader.
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? Review claim status regularly and make recommendations to Team Leader.
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? Prepare and submit unusual or undesirable exposures to Team Leader.
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? Manage hearings and litigation with attorneys.
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? Control and direct vendors and case managers on medical management and return to work initiatives.
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? Comply with customer service requests and file status notes.
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? File workers' compensation forms and electronic data with states for compliance.
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? Refer claims to subrogation and secure necessary information for recovery opportunities.
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? Collaborate with internal teams to exceed customer expectations for claims handling.
Requirements
? Bachelor's Degree preferred.
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? 4 years of relevant experience in workers' compensation or similar examiner experience.
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? Knowledge of workers' compensation statutes, regulations, and compliance.
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? Ability to incorporate data analytics and modeling into daily activities.
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? Exceptional customer service and focus.
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? Strong communication and telephonic skills.
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? High level of organization, follow-up, and accountability.
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? Proficiency with Microsoft Office Products.
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? Claim Adjuster licenses in Connecticut, New Hampshire, Rhode Island, and Vermont are necessary, but not required at the time of posting.
Nice-to-haves
? AIC, RMA, or CPCU completed coursework or designations are a plus.
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? Knowledge of medical terminology is beneficial.
Benefits
? Hybrid work model with flexible remote work options.
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? Comprehensive health insurance coverage.
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? 401k retirement savings plan with company matching.
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? Paid time off and holidays.
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? Professional development opportunities.
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